TN 1 (09-91)

GN 03360.999 Exhibits - Privacy Act Administration

Exhibit 1 - SSA-1723-U4 - Requisition and Receipt for Technical Materials and Instructions (See GN 03360.040.E.)

Exhibit 2 - SSA-1841 - Certification of True Copy (See GN 03360.025.F.)

Exhibit 3 - SSA-1841 A - Certification of True Copy - File Box Copy (See GN 03360.025.F.)

Exhibit 4 - SSA-3179 - Freedom of Information Request (See GN 03360.045)

Exhibit 5 - SSA-3157 - Social Security Administration Facts About Computer Matching Programs (See GN 03360.015)

Exhibit 6 - SSA-5000 - Collection and Use of Information by the Social Security Administration (See GN 03360.015)

Exhibit 7 - SSA-4641-U2 - Authorization for the Social Security Administration to Obtain Account Records From a Financial Institution (8-94) (See GN 03360.050.A.2.)

Exhibit 1 - SSA-1723-U4 (Requisition and Receipt for Technical Materials and Instructions)

Exhibit 2 - SSA-1841 - Certification of True Copy

Exhibit 3 - SSA-1841 A - Certification of True Copy - File Box Copy

Exhibit 4 - SSA-3179 - Freedom of Information Request - Front

Exhibit 4 - SSA-3179 - Freedom of Information Request - Back

Exhibit 5 SSA-3157 - Social Security Administration Facts About Computer Matching Programs

Exhibit 6 SSA-5000 - Collection and Use of Information by the Social Security Administration

To view the form, go to SSA-5000.

Exhibit 7 SSA-4641-U2 - Authorization for the Social Security Administration to Obtain Account Records From a Financial Institution (page 1)

Exhibit 7 SSA-4641-U2 - Authorization for the Social Security Administration to Obtain Account Records From a Financial Institution (page 2)

Exhibit 7 SSA-4641-U2 - Authorization for the Social Security Administration to Obtain Account Records From a Financial Institution (page 3)

Exhibit 7 SSA-4641-U2 - Authorization for the Social Security Administration to Obtain Account Records From a Financial Institution (page 4)


To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0203360999
GN 03360.999 - Exhibits - Privacy Act Administration - 12/27/2011
Batch run: 12/27/2011
Rev:12/27/2011