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1974 privacy act statement form

Privacy act of 1974 form-2025

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The document is a Privacy Act Statement regarding health care records, outlining the authority for collecting personal information, including Social Security Numbers (SSNs). It explains the primary purposes for using this information, which include facilitating health care and complying with legal requirements. The document specifies that while providing information is mandatory for military personnel, it is voluntary for others, although not providing it may affect the comprehensiveness of health care. The statement serves as an acknowledgment of understanding the privacy practices related to health care records.

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What is a Privacy Act form?

. This form is to provide consent to disclosure of your records to another person or entity. This form may also be used if you are the parent of a minor or legal guardian consenting to and authorizing disclosure of records.

What does the Privacy Act of 1974 require contractors to do?

52.224-1 Privacy Act Notification The Contractor will be required to design, develop, or operate a system of records on individuals, to accomplish an agency function subject to the Privacy Act of 1974, Public Law 93-579, December 31, 1974 (5 U.S.C. 552a) and applicable agency regulations.

What is dd form 2923 used for?

DD Form 2923, the Privacy Act Data Cover Sheet, is used to identify and safeguard personally identifiable information (PII) contained in hard copy documents.

What is the Privacy Act of 1974 document?

The Privacy Act of 1974, as amended to present, including Statutory Notes (5 U.S.C. 552a), Protects records about individuals retrieved by personal identifiers such as a name, social security number, or other identifying number or symbol.

What does the Privacy Act of 1974 require contractors to?

Information compiled in reasonable anticipation of a civil action proceeding. Material reporting investigative efforts pertaining to the enforcement of criminal law including efforts to prevent, control, or reduce crime or to apprehend criminals.

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