Revision to page 8 of the SSA-3441

Revised Page 8 for the SSA-3441.pdf

⚠️ Notice: This form may be outdated. More recent filings and information on OMB 0960-0144 can be found here:

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if other than the disabled person

This change was approved for the SSA-3368 (0960-0579) on 2/1/08

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