PERSONS TO CONTACT. A. The VHA contactsare: Xxxxxx Xxxxxxxx Director, Veterans Point of Service Systems Management Chief Business Office U.S. Department of Veterans Affairs 000 Xxxxx Xxxx Xxxx Xxxxx, Xxxxxxxxxx 00000 Telephone: 000-000-0000 Mobile: 000-000-0000 E-mail: Xxxxxx.xxxxxxxx@xx.xxx. Xxxxxx Xxxxxx, RHIA, MAM, CIPP-US VHA Privacy Office Manager Information Access and Privacy Office Office of Health Informatics (OHI) 10A7B 000 Xxxxxxx Xxxxxx Xxxxxxxxxx, X.X. 00000 Telephone: 000-000-0000 E-mail: Xxxxxx.Xx0xxx0@xx.xxx. Xxxxxxxx Xxxxxx, MBA, CHPSE, VHA-CM Director, Health Care Security Requirements Health Information Governance (HIG) VHA, Office of Health Informatics (OHI) (10A7) 000 Xxxxxxx Xxxxxx, X.X. Xxxxxxxxxx, X.X. 00000 Telephone: 000-000-0000 E-mail: Xxxxxxxx.Xxxxxx@xx.xxx.
B. The CMS contacts are: Xxxxxxxxx Xxxx, Acting Director, Verifications Policy & Operations Branch Eligibility and Enrollment Policy and Operations Group Center for Consumer Information and Insurance Oversight Centers for Medicare & Medicaid Services 0000 Xxxxxxxxx Xxxxxx Xxxxxxxx, XX 00000 Telephone: (000) 000-0000 E-mail: Xxxxxxxxx.Xxxx@xxx.xxx.xxx Xxxxx Xxxxxx Director Data and Systems Group Center for Medicaid and CHIP Services Centers for Medicare & Medicaid Services 7500 Security Boulevard Mail Stop: S2-22-27 Location: X0-00-00 Xxxxxxxxx, XX 00000-0000 Telephone: (000) 000-0000 E-mail: xxxxx.xxxxxx0@xxx.xxx.xxx Xxxxxx Xxxxx, CMS Privacy Act Officer Division of Security, Privacy Policy & Governance Information Security & Privacy Group Office of Information Technology Centers for Medicare & Medicaid Services Location: N1-14-56 0000 Xxxxxxxx Xxxxxxxxx Xxxxxxxxx, XX 00000-0000 Telephone: (000) 0 00-0000 E-mail: xxxxxx.xxxxx@xxx.xxx.xxx. Xxxxxxx Xxxxxxxxx, Privacy Advisor Division of Security, Privacy Policy & Governance Information Security & Privacy Group Office of Information Technology Centers for Medicare & Medicaid Services Location: N1-14-40 0000 Xxxxxxxx Xxxxxxxxx Xxxxxxxxx, XX 00000-0000 Telephone: (000) 000-0000 E-mail: Xxxxxxx.xxxxxxxxx@xxx.xxx.xxx
PERSONS TO CONTACT. A. SSA Contacts:
PERSONS TO CONTACT. The U.S. Department of Health and Human Services, Administration for Children and Families, Office of Child Support Enforcement contact is:
PERSONS TO CONTACT. Any change of the information pertaining to any contact must be promptly provided, in writing, to the contacts of the other agency.
A. The IRS contacts are:
1. Project Coordinator Xxxxxxxx Xxxxxxx, Reimbursable Program Analyst Internal Revenue Service Governmental Liaison, Disclosure and Safeguards Data Services BLN: 2-Q08.124 0000 Xxxxxx Xxxxxx Xxxxxxxxxxxx, XX 00000 Telephone: (000) 000-0000 Fax: (000) 000-0000 Email: Xxxxxxxx.Xxxxxxx@xxx.xxx
2. Safeguards and Recordkeeping Procedures Xxxxx X. Xxxxxx, Associate Director Internal Revenue Service Governmental Liaison, Disclosure and Safeguards Office of Safeguards 0000 Xxxxxxx Xxxxxx Xxxxx Xxxxxxx, XX 00000 Telephone: (000) 000-0000 Fax: (000) 000-0000 Email: Xxxxx.X.Xxxxxx@xxx.xxx
B. The SSA contacts are:
1. Matching Program
2. Policy, Safeguards and Recordkeeping La’Xxxxx X. Xxxxxxxx, Policy Analyst Office of SSI and Program Integrity Policy Office of Income Security Programs Social Security Administration 6401 Security Boulevard 2-C-19 Xxxxxx X. Xxxx Xxxxxxxx Xxxxxxxxx, XX 00000 Telephone: (000) 000-0000 Fax: (000) 000-0000 Email: Xxxxxxx.X.Xxxxxxxx@xxx.xxx
3. Systems Operations Xxxxx Xxx, Division Director OBIS/DSDRQ Benefit Information Systems Office of Systems Social Security Administration 6401 Security Boulevard, 4313 Xxxxxx X. Xxxx Xxxxxxxx Xxxxxxxxx, XX 00000 Telephone: 000-000-0000/Fax: 000-000-0000 Email: Xxxxx.Xxx@xxx.xxx
4. Information Security Xxxxxx Xxxxxxxxxx Office of Information Security Security Business Analysis Branch Chief DCS Financial Statement Audit Liaison IRS Safeguard Liaison 0000 Xxxxxxxx Xxxxxxxxx 0xx Xxxxx Xxxxxxxxx XX 00000 Telephone: (000) 000-0000 Email: Xxxxxx.Xxxxxxxxxx@xxx.xxx
5. Project Coordinator Xxxxxx Xxxxxx, Program Analyst Office of Data Exchange Office of Data Exchange, Policy Publications, and International Negotiations Social Security Administration 6401 Security Boulevard, 0-X-0-X Xxxxx Xxxxxxxx Xxxxxxxxx, XX 00000 Telephone: (000) 000-0000 Email: Xxxxxx.Xxxxxx@xxx.xxx
PERSONS TO CONTACT. A. SSA Contacts
1) CBSV Project Team
2) User Agreement Liaison CBSV Agreement Coordinator PO Box 33006 Baltimore MD 00000-0000 Telephone: 000-000-0000 Email: xxxxxxxxxxxxxxxx@xxx.xxx
3) Billing and Payment Issues Physical address via U.S. Postal Service or overnight carrier ATTN CBSV Mailstop 2-O-2 ELR DRAC IABT PO Box address:
4) Reporting Lost, Compromised or Potentially Compromised PII Office of Public Service and Operations Support Project Manager: 000-000-0000 Alternate Contact: 000-000-0000
5) For CBSV technical support or questions about web services, email Xxx.Xxxxxxx.Xxxxxxx@xxx.xxx
B. Requesting Party Contacts Company Name: Responsible Company Official: Title: Address: Telephone: Fax: Email:
PERSONS TO CONTACT. A. The U.S. Department of Health and Human Services, Administration for Children and Families, Office of Child Support Enforcement contact is:
B. The state agency contacts are: [NAME]
PERSONS TO CONTACT. A. The U.S. Department of Health and Human Services, Administration for Children and Families, Office of Child Support Enforcement contact for programs is:
B. The U.S. Department of Housing and Urban Development contacts are: Xxxxxxxx Xxxx
PERSONS TO CONTACT. A. USAC and FCC contacts are:
1. Programmatic Issues: Xxxxx Xxx Acting Vice President, Lifeline USAC 000 00xx Xxxxxx, XX, Xxxxx 000 Washington, DC 20005 Tel.: 000-000-0000 Email: xxxxx.xxx@xxxx.xxx Xxxx Xxxxxxxx Managing Director Federal Communications Commission 00 X Xxxxxx XX Washington, DC 20554 Telephone: (000) 000-0000 E-mail: xxxx.xxxxxxxx@xxx.xxx
2. Privacy Issues: Xxxxxxxx Xxxxx FCC Senior Agency Official for Privacy Office of General Counsel Federal Communications Commission 00 X Xxxxxx XX, Washington, DC 20554 Telephone: (000) 000-0000 E-mail: Xxxxxxxx.xxxxx@xxx.xxx
B. The CMS contacts are:
1. Medicaid/CHIP Issues: Xxxxx Xxxxxx Director Data and Systems Group Center for Medicaid and CHIP Services Centers for Medicare & Medicaid Services 0000 Xxxxxxxx Xxxxxxxxx Mail Stop: S2-22-27 Location: S2-23-06 Baltimore, MD 00000-0000 Telephone: (000) 000-0000 E-mail: xxxxx.xxxxxx0@xxx.xxx.xxx Xxxxxxxx Xxxxxxxx Data and Systems Group Center for Medicaid and CHIP Services Centers for Medicare & Medicaid Services 0000 Xxxxxxxx Xxxxxxxxx Location: S2-22-16 Baltimore, MD 00000-0000 Telephone: (000) 000-0000 Email: Xxxxxxxx.Xxxxxxxx@xxx.xxx.xxx
2. Privacy and Agreement Issues: Xxxxxxx Xxxxxxxxx, Privacy Advisor Division of Security, Privacy Policy & Governance Information Security & Privacy Group Office of Information Technology Centers for Medicare & Medicaid Services Mail Stop: N1-14-56 0000 Xxxxxxxx Xxxxxxxxx Baltimore, MD 00000-0000 Telephone: (000) 000-0000 E-mail: Xxxxxxx.Xxxxxxxxx@xxx.xxx.xxx.
PERSONS TO CONTACT.
A. SSA Contacts
1) CBSV Project Team
2) Billing and Payment Issues Physical address via U.S. Postal Service or overnight carrier ATTN CBSV Mailstop 2-O-2 ELR DRAC IABT PO Box address:
3) Reporting Lost, Compromised or Potentially Compromised PII Office of Data Exchange & Policy Publications Project Manager: Xxxxxxx Xxxxxxx 000-000-0000 Alternate Contact: Xxxxxx Xxxxxx 000-000-0000
4) For CBSV technical support or questions about web services, email Xxx.Xxxxxxx.Xxxxxxx@xxx.xxx
B. Requesting Party Contacts Company Name: Responsible Company Official: Title: Address: Telephone: Fax: Email:
PERSONS TO CONTACT. A. The U.S. Department of Health and Human Services, Administration for Children and Families, Office of Child Support Enforcement contacts for programs and security are;
B. Social Security Administration contacts are:
