Form SSS FORM 2 SSS FORM 2 Selective Service System Change of Information Form

Selective Service System

Change of Information Form
HAVE YOU MOVED? CHANGED YOUR ADDRESS?
Postage

From:

Required
Place Stamp
Here

SELECTIVE SERVICE SYSTEM
PO BOX 94637
PALATINE IL 60094-4637

CHANGE OF INFORMATION FORM INSTRUCTIONS
THIS IS NOT A REGISTRATION FORM

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NOTE: Selective Service must already have your record on file to complete this Change of Information Form. Please send update whenever you legally change
your name or change your address previously supplied to Selective Service. (For a quick way to change your address only, go online to the Selective Service Web
site at www.sss.gov.)
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5
1
Print your full name, your date of birth, your Social Security Account Number, Selective Service Number, and mailing adress as shown on your latest Selective
Service Acknowledgment form regardless of the type of change being submitted.
Block 6
If you legally changed your name, print your new name in Block 6 and provide a copy of the legal court order document as proof of the change.
Block 7
Print the address of your current residence if different from Block 5 .

If you need to register,
use SSS Form 1M (UPO).

Block 8
Sign and date your Change of Information Form.
PRIVACY ACT STATEMENT
The Military Selective Service Act, Selective Service regulations, and the President’s Proclamation on Registration require that you provide the indicated information, including your Social Security Account Number if you
have one. The principal purpose of the requested information is to establish or verify your registration with the Selective Service System. This information may be furnished to other government agencies for the stated
purposes on a selective basis.
DEPARTMENT OF JUSTICE - for review and processing of suspected violations of the Military Selective Service Act, or for perjury, and for defense of a civil action arising from administrative processing under such
Act.
DEPARTMENT OF STATE & U.S. CITIZENSHIP AND IMMIGRATION SERVICES - for collection and evaluation of data to determine a person’s eligibility for entry/reentry into the United States and for U.S. citizenship.
DEPARTMENT OF DEFENSE & U.S. COAST GUARDIRUH[FKDQJHRIGDWDFRQFHUQLQJUHJLVWUDWLRQFODVVL¿FDWLRQLQGXFWLRQDQGH[DPLQDWLRQRIUHJLVWUDQWVDQGIRULGHQWL¿FDWLRQRISURVSHFWVIRUUHFUXLWLQJ
DEPARTMENT OF LABORWRDVVLVWYHWHUDQVLQQHHGRIGDWDFRQFHUQLQJUHHPSOR\PHQWULJKWVDQGIRUGHWHUPLQLQJHOLJLELOLW\IRUEHQH¿WVXQGHUWKH:RUNIRUFH,QYHVWPHQW$FW
DEPARTMENT OF EDUCATIONWRGHWHUPLQHHOLJLELOLW\IRUVWXGHQW¿QDQFLDODVVLVWDQFH
OFFICE OF PERSONNEL MANAGEMENT & U.S. POSTAL SERVICE - to determine eligibility for employment.
DEPARTMENT OF HEALTH AND HUMAN SERVICES - to determine a person’s proper Social Security Account Number and for locating parents pursuant to the Child Support Enforcement Act.
STATE AND LOCAL GOVERNMENTS - to provide data which may constitute evidence and facilitate the enforcement of state and local law.
U.S. CENSUS BUREAU - for the purposes of planning or carrying out a census or survey or related activity pursuant to the provisions of Title 13.
ALTERNATIVE SERVICE EMPLOYERS - for exchange of information with employers regarding a registrant who is a conscientious objector for the purpose of placement and supervision of performance of alternative
service in lieu of induction into military service.
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TO MAIL: PEEL THE SEAL STRIPS OFF, SEAL THE CARD, AFFIX POSTAGE, THEN MAIL.

SELECTIVE SERVICE SYSTEM
Change of Information Form
DO NOT WRITE IN THE ABOVE SPACE

(Last)

3

SOCIAL
SECURITY
ACCOUNT
NUMBER

5

MAILING
ADDRESS
ON FILE

(First)

2

(Middle)

4
(Number)

DATE
OF
BIRTH
(Mo)

(Yr)

SELECTIVE
SERVICE
NUMBER

(Street)

(City)

(Day)

(State or Foreign Country)

(Apt. No.)

(Zip Code)

Enter changes only in Blocks 6 and 7.

6

NAME
CHANGE

7

CURRENT
MAILING
ADDRESS

/DVW



)LUVW

(Number)

(City)

8



TODAY’S
DATE





(Street)

(State or Foreign Country)

0LGGOH



6XIÀ[

(Apt. No.)

(Zip Code)

SIGNATURE OF REGISTRANT
FPI-PET

SSS FORM 2 (JULY 2011) OMB APPROVAL: 3240-0003

1

FULL
NAME