Form SSA-2512 Pre-1957 Military Service--Federal Benefit Questionnaire

See Revised Privacy Act Statement

See Revised Paperwork Reduction Act

SSA will insert the following revised Privacy Act Statement into the form
at its next scheduled reprinting:
Privacy Act Statement for SSA 2512
Section 217, of the Social Security Act, as amended, authorizes us to collect this
information. The information is needed to permit the Social Security Administration
(SSA) to establish whether the wage earner’s military service may used to determine
entitlement to or the amount of Social Security benefits. The information you furnish on
this form is voluntary. However, failure to provide all or part of the information
requested on this form could result in the loss of some benefits or insurance coverage.
We rarely use the information you supply for any purpose other than making a
determination upon your claim. However, we may use it for the administration and
integrity of Social Security programs. We may also disclose information to another
person or to another agency in accordance with approved routine uses, which include but
are not limited to: (1) to enable a third party or an agency to assist Social Security in
establishing rights to Social Security benefits and/or coverage; (2) to comply with Federal
laws requiring the release of information from Social Security records (e.g., to the
Government Accountability Office and Department of Veteran Affairs); (3) to make
determinations for eligibility in similar health and income maintenance programs at the
Federal, State, and local level; (4) to State agencies to assist in the determination process
for initial and continuing eligibility in their incme maintenance programs; (5) to the
Department of Education for determining the eligibility of applicants for Basic
Educational Opportunity Grants; and (6) to facilitate statistical research, audit or
investigative activities necessary to assure the integrity of Social Security programs.
We may also use the information you provide in computer matching programs. Matching
programs compare our records with records kept by other Federal, State or local
government agencies. Information from these matching programs can be used to
establish or verify a person’s eligibility for Federally-funded and administered benefit
programs and for repayment of payments or delinquent debts under these programs.
A complete list of routine uses for this information is available in Systems of Record
Notices 60-0089 and 60-0103. The notices, additional information regarding this form,
and information regarding our programs and systems, are available on-line at
www.socialsecurity.gov or at your local Social Security office.

The following revised PRA Statement will be inserted into the form at its
next scheduled reprinting:
Paperwork Reduction Act Statement - This information collection meets the
requirements of 44 U.S.C. § 3507, as amended by section 2 of the Paperwork Reduction
Act of 1995. You do not need to answer these questions unless we display a valid Office
of Management and Budget control number. We estimate that it will take about 10
minutes to read the instructions, gather the facts, and answer the questions. Send only
comments relating to our time estimate above to: SSA, 6401 Security Blvd, Baltimore,
MD 21235-6401.