<b>Did you hear the Privacy Act statement while you were waiting?</b> If not, I'll read it to you now, or just tell me if I need to read it to you again.</p>
FEMA is required by law to give you a copy of the Privacy Act Statement.</p>
<p>The Privacy Act of 1974 protects your rights as to how FEMA uses and shares your information with entities such as states, tribes, local governments, and other organizations. The Stafford Act and other laws allow FEMA to collect information to determine eligibility and provide assistance after a Presidentially declared disaster.</p>
<p>If you get FEMA assistance and your insurance or other sources cover the same loss, you may be required to return some or all of the FEMA assistance you received.</p>
<p>To qualify for assistance, you must declare that you or someone in your household is a citizen, non-citizen national, or a qualified alien of the United States. If you provide false information or lie in an attempt to get assistance, it violates federal and state laws, which carry criminal or civil penalties or both.</p>
<p>You authorize FEMA and the state, tribe, or local government to verify all of the information you provide and request documentation from your insurance company, or other third parties, to determine your eligibility for assistance.</p>
<p>The disclosure of information, including the Social Security number, on this form is voluntary; but failure to provide the information we request may delay or stop you from getting disaster assistance.</p>
<p><b>Do you confirm that you heard and accept the Privacy Act statement?</b></p>
<p><b>Do you confirm that someone in your household is a citizen, non-citizen national, or qualified non-citizen of the United States?</b></p>
