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US Social Security Administration Authorization

Anyone selling Social Security Administration ( “SSA”) related documents, forms or publications (“documents”) affirms that he/she has obtained any required authorization from SSA (20 C.F.R. § 422.527) and that the use and/or sale of such documents is in compliance with Section 1140 of the Social Security Act (42 U.S.C. § 1320b-10) and its implementing regulations (20 C.F.R. Part 498). Section 1140 of the Social Security Act prohibits the use of SSA words, letters, and symbols to convey a false impression of a connection with SSA. Section 1140 also prohibits the fee-based reproduction, reprinting, or distribution of SSA forms, applications, or other publications without authorization from SSA. Anyone violating Section 1140 is subject to a separate fine up to $5,000 per violation (i.e., a separate fine for each fee-based copy reproduced, reprinted, or distributed without authorization from SSA).

Visit SSA’s official website at http://www.socialsecurity.gov/online/thirdpartyforms.html to learn more about the applicable Federal law, regulation and SSA policy pertaining to the requirements for third party use of SSA-related documents. Anyone suspecting fraud relating to any SSA document or program may report the matter to the Social Security Administration, Office of the Inspector General (“SSA-OIG”) by calling 1-800-269-0271 or by visiting the SSA-OIG’s website at http://oig.ssa.gov/report.

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