Addendum to the Supporting Statement for 0960-0116

Addendum - 0116.doc

Child Relationship Statement

Addendum to the Supporting Statement for 0960-0116

OMB: 0960-0116

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Addendum to the Supporting Statement for Form SSA-2519
Child Relationship Statement

20 CFR 404.355 & 404.731
OMB No. 0960-0116



Terms of Clearance


OMB approves this revision consistent with SSA agreement in writing on 5/11/07.

SSA will circulate a new instrument standardizing the form's terminology to use a single phrase for "worker" and separate the purpose of the form from the Privacy Notice.


In response to the Terms of Clearance, SSA is revising the form to use the word “worker” in all of the instances necessary, thereby removing all other phrases. Also, SSA's Office of the General Counsel revised the Privacy Act Statement to be in compliance with both the Term of Clearance and as a part of their systematic review of SSA’s Privacy Act Statement on agency forms.


SSA did not enact this change sooner as we did not need to reprint the form since the last revision. However, since we are renewing the OMB approval, we are officially making these changes now and will implement them upon approval. We will continue to use old stock until it is depleted prior to reprinting the new version of the form.

File Typeapplication/msword
File TitleAddendum to the Supporting Statement for Form SSA-2519
Author177717
Last Modified By666429
File Modified2009-12-30
File Created2009-10-27

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