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Social Security Administration
Office of Central Records Operations
FOIA Workgroup
P.O. Box 17772
300 N. Greene Street
Baltimore, Maryland 21290
Re: Freedom of Information Act Request
Dear Freedom of Information Officer,
I am writing this request under the Freedom of Information Act, 5 U.S.C. Section 552. I hereby request the Social Security File (including the SS-5, Application for Social Security Card) for the following individual:
CLEMENS, HENRY
468-03-5321
Birth: 16 Mar 1900
Death: Aug 1968
This individual is deceased, having been listed in the Social Security Administration's Death Master File. I understand the fee for this service is $7.00 when the Social Security Number is provided. Included is a check for $______ made out to the Social Security Administration to cover any administrative costs required by this request.
Please respond to my request upon receipt of this initial correspondence. Thank you for your attention and assistance.
Sincerely,
Address:
Daytime Phone Number:
HENRY CLEMENS 16 Mar 1900 Aug 1968 55421 (Minneapolis, Hennepin, MN) (No Location Given) 468-03-5321 Minnesota (Before 1951)
Social Security Death Index found on www.Ancestry.com
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