Addendum to the Supporting Statement for 0960-0001

Addendum to Supporting Statement

Internet Request for Replacement SSA-1099/1042S

20 CFR 401.45

OMB No. 0960-0583

Terms of Clearance

This collection is approved consistent with the changes agreed upon in writing by

SSA on 5/11/07. SSA will circulate a new form separating the purpose of the form from the Privacy Notice and replace "public or private aid" with the phrase "public welfare or private charitable contributions" in question 15.

SSA has met the Terms of Clearance. We separated the purpose of the form from the Privacy Notice, and replaced “public or private aid” on question 15 with the phrase “public welfare or private charitable contributions.”

Minor Revisions to the Collection Instrument

SSA is making the following revisions:

We are revising the PRA statement to reflect our current boilerplate language.  The current language, which dates back to the last reprint of the form, is now outdated.

SSA’s Office of the General Counsel is conducting a systematic review of SSA’s Privacy Act Statements on agency forms. As a result, SSA is updating the Privacy Act Statement on the first page of the form.