Form 1 Selective Service Registration Form 1

From:

PRIVACY ACT STATEMENT

REGISTER

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 GUARD - for exchange of data
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DEPARTMENT OF LABOR - to assist veterans in need of data concerning
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Workforce Innovation and Opportunity Act.
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assistance.
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 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.
BUREAU OF CENSUS - 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.
GENERAL PUBLIC - Registrant’s name, Selective Service registration
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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 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.

18 - 25 years old

Failure to provide the required information may violate the Military
Selective Service Act. Conviction for such a violation may result in
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SELECTIVE SERVICE SYSTEM
P.O. BOX 94739
PALATINE, IL 60094-4739

POSTAGE
REQUIRED

HERE

PLACE STAMP

It’s Quick - It’s Easy - It’s the LAW
Selective Service System
National Headquarters
Arlington, VA 22209-2425
www.sss.gov

Men Ages

By registering, a young man stays eligible for:
- U.S. Citizenship for male immigrants
- Student financial aid (federal and most states) and even admission
to some state schools
- Job training benefits
- Most federal jobs and jobs with the U.S. Postal Service

PHONE NUMBER:

AGENCY USE
TODAY’S DATE: (MM-DD-YYYY)

ELECTRONIC MAILING ADDRESS: (EMAIL ADDRESS)

Male

SEX: (Mark with “X”)

Female

CITY:

Register at www.sss.gov or
your local post office.

CURRENT MAILING ADDRESS: (STREET ADDRESS & APARTMENT NUMBER)

• Within 90 days, you should receive a Registration Acknowledgement containing
your Selective Service Number.
• You can also verify your Selective Service Number by going to www.sss.gov.
• MOVING - You are required, by Federal law, to submit an address change. You
can do it online at www.sss.gov or at your local Post Office.

FIRST NAME & MIDDLE NAME

After Registration

LAST NAME:

By registering, a man’s voluntary participation helps provide a hedge against
unforeseen threats. It is a relatively low-cost insurance policy for our Nation.

DATE OF BIRTH: (MM-DD-YYYY)

INSURANCE FOR THE NATION

SSS FORM 1M (04-30-2021)

It’s your responsibility to ensure that young men, 18 - 25, understand the law so
they can make an informed decision about registration compliance. Currently, more
than 90 percent of eligible young men are registered. It’s a civic duty of every young
man to comply with the law.

OMB APPROVAL 3240-0002

CIVIC DUTY

PRINT ONLY IN BLACK INK AND IN CAPITAL LETTERS ONLY

By registering all eligible young men, the Selective Service System ensures a
fair and equitable draft, if ever required; however, there has not been a draft
since 1973.

SELECTIVE SERVICE SYSTEM REGISTRATION FORM

FAIRNESS AND EQUALITY

We estimate the public reporting burden for this collection will vary from two minutes per response, including time for reviewing instructions, searching existing data sources, gathering data, and completing and reviewing the
information. Send comments regarding the burden statement or any other aspects of the collection of information, including suggestions for reducing this burden to: Selective Service System, SSS Forms Officer (3240-0002),
Arlington, VA 22209-2425. The OMB control number 3240-0002, is currently valid. Persons are not required to respond to this collection unless it displays a valid OMB control number.

PROTECT ELIGIBILITIES FOR FUTURE BENEFITS

SIGNATURE

I AFFIRM THE FOREGOING STATEMENTS ARE TRUE

ZIP CODE:
STATE:

SOCIAL SECURITY NUMBER:

Virtually all Men living in the United States and U.S. citizens living abroad must
register at 18 with Selective Service. Men may pre-register at 17 years and 3
months and when they turn 18, they will automatically be registered. Men 18 - 25
years old remain in a database for national emergencies, requiring a future rapid
expansion of our Armed Forces.

III

IT’S THE LAW

JR

Why Register?

OTHER SUFFIX:

Male U.S. citizens and immigrants, documented and undocumented, residing in the U.S.
and its territories must register if they are age 18 through 25.

SUFFIX: (Mark with “X”)

Who Must Register?

UPO

DO NOT WRITE IN THIS SPACE

You Must Register with
Selective Service