Annual Performance Report
Note to Data Collector: When you collect this information from participants, please make sure that you inform them why they are being asked to provide Social Security numbers. Please see Privacy Act statement below.
In accordance with the Privacy Act of 1974 (Public Law No. 93-579, 5 U. S.C. 552A), you are hereby notified that the Department of Education is authorized to collect information to implement the Upward Bound program under Title IV of the Higher Education Act of 1965, as amended (Pub. Law 102-325, sec. 402C). In accordance with this authority, the Department receives and maintains personal information on participants in the Upward Bound program. The principle purpose for collecting this information is to administer the program, including tracking and evaluating participants’ academic progress. Providing the information on this form, including a Social Security number (SSN), is voluntary; failure to disclosure a SSN will not result in denial of any right, benefit, or privilege to which the participant is entitled. The information that is collected on this form will be retained in the program files and may be released to other Department officials in the performance of official duties.
[This document is dated January 2016.]
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