Railroad Employment Questionnaire

SSA will insert the following revised Privacy Act Statement into the form as soon
as possible:
Privacy Act Statement
Collection and Use of Personal Information
Sections 205(i) and 205(o) of the Social Security Act, as amended, allow us to collect this
information. Furnishing us this information is voluntary. However, failing to provide all or part
of the information may prevent an accurate and timely decision on any claim filed.
We will use the information you provide to coordinate Social Security claims processing with the
Railroad Retirement Board (RRB) and determine benefits eligibility. We may also share the
information for the following purposes, called routine uses:
•

To the RRB, for the purpose of administering provisions of the Social Security Act
relating to railroad employment; and

•

To Federal, State, or local agencies (or agents on their behalf), for administering
income or health maintenance programs including programs under the Social Security
Act.

In addition, we may share this information in accordance with the Privacy Act and other Federal
laws. For example, where authorized, we may use and disclose this information in computer
matching programs, in which our records are compared with other records to establish or verify a
person’s eligibility for Federal benefit programs and for repayment of incorrect or delinquent
debts under these programs.
A list of additional routine uses is available in our Privacy Act System of Records Notice
(SORN) 60-0089, Claims Folders System, as published in the FR on October 31, 2019, at 84 FR
58422. Additional information, and a full listing of all of our SORNs, is available on our website
at www.ssa.gov/privacy.