nd.gov - The Official Portal for North Dakota State Government
North Dakota: Legendary. Follow the trail of legends

Forms Content

Privacy Act Statement

As part of the Privacy Act of 1974, agencies are required to provide a Privacy Act Statement to all individuals asked to provide their social security number. The Privacy Act Statement must include the following information:

  • Authority: The legal authority for collecting the information and whether disclosure of such information is mandatory or voluntary;
  • Purpose:  The purpose(s) for which the information will be used; and
  • Effect(s) of not providing the information, if any. 

A statement that summarizes this information must be included on any forms requesting a social security number.

Related Service


What Our Customers Are Saying

Appreciate the streamlined support.

Pembina County Auditor
August 24, 2015