U.S. DEPARTMENT OF JUSTICE pee curges. form your personnel offen. (n eecorttunes with De provtaions of tho Prisacy Act of ‘nnntason of ear cita's WARDATORY, cer cents Toque | VOLUNTARY busts for the scfaty and conentance \rammdinte he appioabie Prracy Act Stramera. Cartatn portions of tho form aro to bo camptotad by the arployod's personnal eftion or of Ore oer, cOnsua your porsarndd fica, PRIVACY ACT STATEMENT: SOCIAL SECURITY NUMBER-1: AUTHORITY: Exncutve Onder 0397 cated November 22, 182 2 PURPOSE AND USE The Sock Senaty Numbor (S6N) bs usod os a urtque Iddartior for matching locator rocards to records hi parsornel und payrad faa. Uso of fo BEN ansures corroct iden®iceton of records for exptoyoss with Pe sume camo 3 EFFECTS OF NCN-CISCLOSURE Cisconuro of tio SEN Is MANDATORY. Fedire © Gsdieso tho SSN on aocesson wil resi in your payrod chack not been procossed, Fetce to Gsciose he SEN win reporting changes wo rest hn ho CURRENT RESIDENCE ADDRESS FOR TAX PURPOSES CE AE EE: ER CAND AIT SDD, ‘Secton 6516, 6817 ard GERX 28 U.S.C. Sectors 600! end 108. 2. PURPOSE AND USE: Tomact So mparing roguremers of Federal, Ste end Locd mx Address |p MANDATORY . Faure © ductose tw asrert Reskiance Ackress on accession wi tn vietation of the ctied exhorties and persia peattas as Nama, St, Or., PL, ets.) PRIVACY AGT STATEMENT: RESIDENCE ADDRESS AND TELEPHONE NUMBER-1, AUTHORITY: ‘Section S01. 2 PURPOSE AND USE: To contact employees &: Set residence on meters of Go Micha methiso rotating to trar enpioynert with the Ouparcnont af ust. Acooss to tis information is Omited to the ermpioyests superdsor(s) OR bcividusts eertzad by the sparvisoris). 3 EFFECTS OF NON-ONSCLOSURE: Submission cf thts cata ts VOLUNTARY. Ove Gata to not exerted, supervisory personnel aay havo elibouky locating employes to induc en af emmorgency work euacora. PRIVACY ACT STATEMENT: 1. AUTHORITY: Tharo ls no siutery ouPurty tor tho use of thts torreon to enc Departnent ef Justo empioyoes ih to Commuter Chia. Tho Cummmater Chiba spenearad ond (Gpartiad by the iteropoian Wastington Gourd of Trade. Leena haan ora ener nett etbrno eo 2. PURPOSE AND USE To supply pate ae ig een vy ¢ the Commenter CLS wil rent th to errpiqos's rama, hore ecktess, exnpioyar (agency). office | Loustor ters 4, 7, @ 0, 10, 11, 12, 23, SY, 38 40 41, 42 43, 47, end 48) being cont to Se Commuter Cat's acomaind employe name, expioyer (agency), and cfice teieyhone manber (Form OO}253 Employee Locstor tems 4, 38 47, end 45) 3. EFFECTS.OF NON. . Faire discteso wi rasua h ernpioyes not becoring @ mamber of te Commuter ub ert hayutra, no amployes Formation wi be sort pho 18. WASKINGTON, DC METROPOLITAN AREA EMPLOYEES ONLY Y | © Yes, -1wtat to ptr te Comematior Cast N Romeve end pornoral irformation tom tre Comma’ Cab (if you are not Interested In the Commutor Club, skip this question). R peeing ion-anmereynsineieronh ol 41. COUNTY OR FORBIGN COUNTRY ewe ie me Live Lm [7 SEVEN DiOTT NUMBER [= SxTENSIONTEN NUMBER” | Cove onemen Sd PERSON TO BE NOTIFIED INEVENT OF EMERGENCY [62 BUILDINGCODE EFTA00036380