Replaced Section 504 SharePoint Tracker Screens

Section 504 SharePoint Tracker Screen Shots.pdf

Request for Accommodation in Communication Method

Replaced Section 504 SharePoint Tracker Screens

OMB: 0960-0777

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The following Privacy Act and Paperwork Reduction Act Statements will be available for the
respondents to hear (verbally) or read (as printed out by the SSA employee). These Statements
will be accessible for the SSA employees through a link on the Home Page for the Section 504
SharePoint Tracker:
Privacy Act Statement
Collection and Use of Personal Information
Section 504 of the Rehabilitation Act of 1973 (29 U.S.C. § 794) allows us to collect this
information. We will use the information you provide to process your request for reasonable
accommodation.
You do not have to give us the information. Your responses are voluntary. However, failing to
provide us with the requested information could prevent us from providing you with the
accommodation you have requested.
We rarely use the information you give us for any purpose other than for processing your request
for accommodation. However, we may disclose information in accordance with the Privacy Act.
For example, we may disclose the information within the agency on a need to know basis,
pursuant to a court order, and to other agencies (e.g., Bureau of the Census and the Government
Accountability Office) for research, audit, or investigative activities necessary to ensure the
integrity and improvement of our programs. We may also disclose information pursuant to
routine uses, as provided by the Privacy Act, such as the following:
1. To the Department of Justice for investigating and prosecuting violations of the Social
Security Act, representing the Commissioner, or investigating issues of fraud by agency
officers or employees;
2. To contractors and other Federal agencies to assist us in running our programs; and,
3. To a congressional office assisting the subject of a record.
A complete list of routine uses for this information is available in our systems of records, which
are available on our Internet website at www.socialsecurity.gov or at your local Social Security
office.
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
(OMB) 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


File Typeapplication/pdf
SubjectScreen Capture by Snagit
AuthorSnagit User
File Modified2014-06-11
File Created2013-12-20

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