Community Coffee Privacy Act Statement 


	  


	Regarding Collection of Employee Social Security Numbers 


	  


	Authority: Executive Order 9397 (3 C.F.R. (1943-1948 Comp.) 283-284; Executive Order 13478 set forth at 73 Fed. Reg. 70239 (Nov. 20, 2008); Public Law 104-134 (April 26, 1996). 


	  


	Principal Purposes: Community Coffee will use your Social Security Number in its personnel administration in order to verify employee identity, for evaluation of employment qualifications, to obtain and verify employee work history and other background information, for payroll processing purposes, for state and federal income taxation reporting or tax crediting purposes, for social security income reporting purposes, for worker’s compensation benefits administration, for leave application and administration purposes under the Family and Medical Leave Act or any disability plan, for drug testing, to obtain driving records and history, for federal employment requirements and identification, citizenship, military service verification purposes, and to provide the information to its administrators/insurance carriers for their administrative purposes in the provision and administration of retirement, leave, health, and other welfare and fringe benefits to Community Coffee employees. 


	  


	Routine Uses: The information will be maintained by Community Coffee in a system of records and used by and disclosed to Community Coffee personnel, the Department of Veterans Affairs (“VA”), to the Department of Defense (“DOD”), to Community Coffee’s workers compensation administrator/insurance carrier when a claim is filed or administered, to Community Coffee’s administrators/insurance carriers, to Community Coffee’s payroll processing company, to state and federal tax reporting agencies, to other federal agencies regarding your employment qualifications, to agencies or companies to verify your employment qualifications and background information, and to drug testing laboratories. The VA Routine Uses set forth at 65 Fed. Reg. 45131 (Jul. 20, 2000), the DOD Blanket Routine Use set forth at 71 Fed. Reg. 40282 (Jul. 14, 2006) and the government-wide Office of Personnel Management Routine Use set forth at 65 Fed.Reg. 24732 (Apr. 27, 2000) apply. 


	  


	Disclosure: Furnishing your Social Security Number is voluntary; however, failure to furnish the requested information may delay or prevent the provision of and administration of your employee benefits, payroll processing, and other personnel administration functions.