SOCIAL SECURITY

TEH2A April 11,2017

173010EB

Mr. Carl L. Sanders, Jr.

- .

_________ _. ._
Dear Mr. Sanders:
0" ~~__ _ _. ~r ._~ ~_~- _._-- ----~--.----.---~----- -'------ -------

Thank you for your February 4, 2017 letter to the Social Security Administration (SSA)
referring to your ethnicity and race identification in our records. -

The Form SS-5, Applicationfor a Social Security Card, has always contained a voluntary
question related to race/etlui1city. Applicants for an original Social Security number
(SSN) or replacement SSN card are not required to answer the race/ethnicity question.
We will process the Form SS-5 regardless of whether the applicant has provided
race/ethnicity information, We request race information for research and statistical
purpose only.

We create a Numident record when a person applies for an original SSN card. The
Numident is the electronic database that contains SSA's records ofSSNs assigned since
1936. Each time an individual applies for a replacement SSN card, we establish a new
entry in his or her Numident record.

To update information on the Numident, including race, you must submit a Form SS-5
for a replacement SSN card and evidence of identity to prove identity only; you do not
-need to provide documentation to prove the race selected. To prove identity, you must
submit one unexpired, valid document of identity, such as a u.s. driver's license or state
issued non-driver identity card.

You can complete, sign, and mail the enclosed Form SS-5, Applicationfor a Social
Security Card, with supporting identity evidence to your local Social Security office
located at 64285 Highway 434, Lacombe, LA 70445-5416 (telephone 866-887-8997).

Enclosure

SOCIAL SECURITY ADMINISTRATION BALTIMORE, MD 21235-0001

SOCIAL SECURITY ADMINISTRATION Form Approved
~Dlication for a Social Security Card OMB No. 0960-0066

NAME' Rrst FuR Middle Name

TO BE SHOWN ON CARD (i-'~P..L L/N N
1 FUll NAME AT BIRTH FIISt FuB MIddle Name
IF OTHER THAN ABOVE
OTHER NAMES USED

t s- -~
~
, - .F
..

PLACE D Office
Use
DATE
010/131/157
3 OF BIRTH .ptrfDJ\J ROUGt::. LDLt 1051 A IJ A Only 4 OF
(Do Not Abbreviate) City State or Foreign Country FCI BIRTH MMIDD/yyyy

LegalAllen LegalAlienNot Other

5 CITIZENSHIP II U.S. Citizen 0 Allowed To 0 Allowed To Wol1c (See [J (See lostructions
(Check One) WoI1c li1Structions On Page 3) On Pa~ 3}

ETHNICITY RACE D Native Hawaiian B'American Indian Q.pllier .Pacific Island

0 Alaska Native 0 .Black/African American HWhite
6 AreYouHispanic or Latino?
(Your Response is Voluntary) 7 Select One or More
{Your Response is Voluntary} O. As~n .. "" _ .."._-_ .....
,.,_
DYes" aNa
8..SEX
..
I2t'Male o Female
Full Middle Name
A. PARENTIMOTHER'S First
NAME AT HER BIRTH LE OiJ0K-.A
9 B. PARENT/MOTHER'S SOCIAL SECURITY
i, 0 Unknown
NUMBER (See instructions for 9 B on Page 3) =1' ~

Full Middle Name Last

A. PARENT/FA THER"S FlfSt

NAME IfARL LINN (ANfJ6.R~

10 B.PNAURENT/FATHER'SSOCIALSECURITY
MBER (See instructions for 10B on Page 3)
I I I I-I II~
L..-l..-J
L~L.J bUnknown

Has the person listed in item 1 or anyone acting on his/her behalf ever filed for or received a Social Security number
111ca~dbore?' I .
.
Don't Know (If ~don't knOW,D
s (If "yes" answer questions 12-13) 0 No D skip toque..-tion 14.}
Name shown on the most recent Social First FuUMiddleName last
12 Security card issued for the person
listed in
item 1 CARL LiNN
13Enter ~ny different date of birth if used on an
..
earlier application for aeard NYYY >

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os/J<40r7 iSDAYTIME 1). __ I -

MMlDDiYYYY PHONE NUMBER AreaCode Number

. DR.,streetf.Qdres . apt No. PO Box, Ri' Route /\In - -

16 MAILING ADDRESS
-
'.
citY
:0 .=... I/t. '_~J~Ic.a~IJ.!:.!.lSl~-A~tJ~U-_----=;~:::::t::'~_
State1Foreign Counlly , ZIP Code
(Do Not Abbreviate) _

I de<;l~ under ~Ity of penury that I ~e E!X3lTIined aU the Information on this form, and on any accompanying statements or forms.
and It I,. true anCi correct to tHe 6est of my knowledge.

17 VpUf;r. iSiU;NATU ~E l 18 YOUR RElA. TIONSHIP TO. THE PERSON IN ITEM 1 IS:
C-1lJ\HJ( iJ/~ d ~ \~. . EJSeIf 0 ~~~Parent
0 ~~ran 0 Other(Specify}

DO NOT WRI IE BELOW THI~ LINE (FOR SS USE ONLy) =:=;O',"""",,",,-*,",' """""'"'" -.------ == =
NPN' [ooc JNTI CAN [rrv
PBC I, IEVI lEVA IEVC IPRA NWR IDNR IUNIT
EVIDENCE SUBMITIED SIGNATURE AND 11n..E OF EMPLOYEE{S)REVlEWING
EVIDENCE AND/OR CONDtJCTlNG INTERVIEW

DATE

DeL DATE'

Fonn SS-5-FS (08-2011) ef (08-2011) Destroy Pnor Editions Page 5

 DateStamtT"',~
0

.7' 0

-s,

Postage $RE668128Ctl ~ Services &: Fee~(

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Extra.Servi~.o
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Mau'$_o ._..... __o ...
O~ignatureConfirmati.
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Welcome To ORetum Receipt .... . .. c:- 0 Signature Confum$Ori

{hardcopy}$ $12. ",I Restricted Delivery\:;;~
0

$ i~.O 0

ORetumReceipt . .. __ . .. \, 7.
(eleclronic)$ !~I ~I:' Total Postage & F~;~9
Social Security ORestricted DelivetJ.~. $ \,-
CustomerMust 0 are" ~ Receivd by
Full Value $14.11
BATON ROUGE LA $

Your ticket number is

A214

Thank you. Please wait

to be called. Try using
our online 'services at
www.socialsecurity.gov
5/23/201709:57:15 AM
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Tracking Number: RE224188368US

Updated Delivery Day: Thursday, February 16, 2017

Product & Tracking Information Available Actions

Postal Product: Features:
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OATE&TIME STATUS OF ITEM LOCATION Email Updates

February 16, 2017 ,2:27

Delivered BALnMORE, MD 21235
pm

Your item was delivered at2:27 pm on February 16,2017 in BALTIMORE 1\10 21235.

February 16, 2017,8:50 am Sorting Complete BALnMORE, MD 21235

February 16, 2017 , 8:49 am Arrived at Unit BALTIMORE, MD 21233

NORTH
February 13, 2017 , 5:09 pm Departed USPS Facility
HOUSTON, TX 77315

February 12,2017 , 8:13 pm In Transitto Destination

NORTH
Febru ry 12, 2017 , 9:40 am Arrived at USPS Facility
HOUSTON, TX 77315

Febru ry 11, 2017 , 9:54 pm Departed USPS Facility BATON ROUGE, LA 70810

Febru ry 11, 2017 , 9:52 pm Arrived at USPS Facility BATON ROUGE, LA 70810

Febru ry 11, 2017,10:57

Acceptance BATON ROUGE, LA 7081 0
am

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