Form SSA-8552 Interview Confirmation

Form Approved
OMB No. 0960-0189

Social Security Administration

PLEASE COMPLETE AND RETURN THIS FORM TO
ME«SNO_RETURN_INSTRUCTION»
Interview Confirmation
Claim Number: XXX-XX1.

I / We will be available for your interview as scheduled.
YES
NO
If NO, please phone me as soon as possible to set a better time.

2.

My telephone number is: (

3.

My address is:

4.

Signature:
Date:

Form SSA-8552 (08/2011)

)

.

Privacy Act Statement
Collection and Use of Personal Information

Sections 205(a), 228(a), 1614(a) and 1836 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 us from verifying your eligibility for benefits.
We will use the information to check data for accuracy and to verify documentation used to establish your eligibility
for benefits. We may also share your information for the following purposes, called routine uses:
1.

To third party contacts in situations where the party to be contacted has, or is expected to have, information
relating to the individual’s capability to manager their affairs or eligibility for or entitlement to benefits
under the Social Security program when the data are needed to establish the validity of evidence or to
verify the accuracy of information presented by the individual; and

2.

To contractors and other Federal agencies, as necessary, for the purpose of assisting the Social Security
Administration (SSA) in the efficient administration of its programs. We will disclose information under
the routine use only in situations in which SSA may enter into a contractual or similar agreement with a
third party to assist in accomplishing an agency function relating to this system of records..

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 Notices (SORN) 60-0040, entitled
Quality Review System; and, 60-0090, entitled Master Beneficiary Record. Additional information and a full listing
of all our SORNs are available on our website at www.socialsecurity.gov/foia/bluebook.