NOTIFICATION OF
SOCIAL SECURITY NUMBER
COLLECTION AND USAGE
In compliance with Florida Statute 119.071(5), this document serves to notify you of the purpose for
the collection and usage of your Social Security number (SSN).
Pasco-Hernando State College (PHSC) collects and uses your SSN only for the following
purposes in performance of the college’s duties and responsibilities. To help protect your identity,
PHSC policies and procedures prohibit the release or disclosure of your SSN to unauthorized
parties contrary to state and federal law and assigns you a unique student or employee
identification number. This unique ID number is used for all associated employment and
educational purposes at PHSC.
Your SSN may be used to for the following:
• Federal I-9 (Department of Homeland Security)
• Federal W4, W2, 1099 (Internal Revenue Service)
• Federal Social Security taxes (FICA)
• Distributing Federal W2 (Internal Revenue Service
• Unemployment reports (Florida Department of Revenue)
• Florida Retirement Contribution reports (Florida Department of Revenue)
• Workers Comp claims (FCSRMC and Department of Labor)
• Direct deposit files
• Supplemental individual retirement account contribution reports
• Group health, life and dental coverage enrollment
• Supplemental insurance and flexible benefit deduction reports
• Work study work assignments
• Background checks
• Memberships in voluntary organizations where you authorize the release
Providing your Social Security card is a condition of employment at PHSC. For specific
references to legal authority that authorizes or requires collection and use of your Social Security
Number, please reference the attached chart.
I understand the above information and have been given a copy of collection and usage
purposes.
_________________________ _________________________ ___________
Signature Employee Name Date
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