Current SSA-1383

See Revised Privacy Act
Statement

See Revised PRA

Student Reporting Form, Form, SSA-1383
Privacy Act Statement
Collection and Use of Personal Information

Sections 202(d) and 203 (f) of the Social Security Act as amended [42 U.S.C. 402(d) and
403(f)] and Title 20 CFR 404.415, 404.434, 404.435 (b) (2), 404.367, 404.368, and
422.135, authorize us to collect this information. The information you provide will help
us determine your entitlement to benefits. The information you provide is voluntary.
However, your failure to provide all or part of the requested information could prevent us
from making an accurate and timely decision concerning your entitlement to benefits.
We rarely use the information you provide on this form for any purpose other than for the
reasons explained above. 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 the following:
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, General
Services Administration, National Archives Records Administration, and the
Department of Veterans Affairs);
3. To make determinations for eligibility in similar health and income
maintenance programs at the Federal, State, and local level; and
4. 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 agencies can be used to
establish or verify a person’s eligibility for Federally-funded or 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 our System of Records
Notice entitled, Claim Folders Systems, 60-0089. The notice, additional information
regarding this form, and information regarding our system and programs, are available
on-line at www.socialsecurity.gov or at any local Social Security office.

SSA will insert the following revised PRA Statement 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 6
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.