Ssa 3105 form 2011-2025

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The document outlines the Privacy Act Statement regarding the collection and use of personal information by the Social Security Administration (SSA) for determining waivers or changes in repayment rates for overpayments. It explains the voluntary nature of providing information, potential disclosures to third parties, and rights related to appealing overpayment decisions through Reconsideration or Waiver requests. Additionally, it provides instructions on how to submit these requests and informs about the time limits and conditions for approval.

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