Confidential Release
of Social Security Number
and Statement of Purpose
Pursuant to Section 119.071 (5), Florida Statutes, social security numbers collected by the City
of Greenacres are confidential and exempt. The requirement to request the social security
number must be relevant to the purpose for which collected and must be clearly documented.
The social security numbers must be segregated on a separate page from the rest of the record.
The requirement for your social security number is mandatory.
Name: __________________________________________
Social Security No. __________________________________________
Section 119.071 (5), Florida Statues, gives authority for the City of Greenacres to collect social
security numbers if it is stated in writing the purpose for its collection and is specifically
authorized by law to do so or it is imperative for the performance of the City’s duties and
responsibilities as prescribed by law. There are many individuals with the same name;
therefore, without this identifying social security number, it would be difficult, if not impossible, to
be reasonably sure that the correct individual(s) are identified and to verify they meet the
requirements of the statutes. The City of Greenacres requires the release of your social security
number for one or more of the following purposes or reasons:
to perform background investigation checks for employment; or
to serve on City Council, boards or commission; or
issuance of business tax receipt(s); or
to conduct 1099 reporting of income for poll workers, vendors or consultants; or
to enroll in specific training courses and classes that require SS#; or
to produce patient insurance billing and/or for patient tracking, or
to provide F.S. required information for Police/Fire/EMS purposes;
to process scholarship award(s) funding for students college tuition;
for reporting necessary to administer workers’ compensation claims, unemployment
compensation claims, and health/dental claims; or
for reporting income paid pursuant to the Internal Revenue Code; or
pension administration; or
for debt collection purposes.
CONFIDENTIAL