U.S. DOD Form dod-va-2278
AMENDMENT TO THE PRIVACY ACT STATEMENT
AUTHORITY: The Computer Matching and Privacy Protection Act of 1988, and the Privacy Act of 1974, as amended, 5 U.S.C. Section 552a.
TO: Applicants for, or recipients of, assistance or benefits under a Federal benefit program, and Federal personnel or applicants for Federal
employment.
PURPOSE: The purpose of this notice is to inform you that the information which is entered on the attached form, as well as any other
information provided to the Department of Veterans Affairs for the purpose for which the form is submitted, may be verified through a computer
matching program as that phrase is defined in the Privacy Act of 1974, as amended. Subsequent information submitted to, or obtained by, the
Department on this matter may also be verified by a computer matching program. Verification of the information through a computer matching
program means that the information may be compared against information of other Federal or state agencies by using a computer. Such computer
matches may be performed at any time in the future.
VA FORM
MAY 1991
73-2278