Addendum to Supporting Statement

Addendum to the Supporting Statement for SSA-3288

Privacy and Disclosure of Official Records and Information;

Availability of Information and Records to the Public;

20 CFR 401 and 402

OMB No. 0960-0566

Justification for Non-Substantive Changes to the Collection

We inadvertently neglected to make the changes at the time we submitted for OMB approval; therefore, we did not implement the approved changes. We are making these changes in the final revision.

Change 1: We are changing the language in the second sentence of the instructions under Instructions for Using this Form to read:

Old Language: If you are the natural or adoptive parent or legal guardian, acting on behalf of a minor, you may complete this form only to release the minor’s non-medical records.

New Language: If you are the natural or adoptive parent or legal guardian, acting on behalf of a minor, you may complete this form to release only the minor’s non-medical records.

Justification 1: We are making this language change for clarification purposes.

Change 2: We are changing the language in the last sentence of the last bullet to read under How to Complete this Form:

Old Language: Proof of relationship may be required.

New Language: We may require proof of relationship.

Justification 2: We are making this language change from passive to active voice.

Change 3: We are adding an asterisk (*) in front of the introductory sentence of the check box section on the form that reads Please release the following information selected from the below list:, and changing the italicized language to read,

Old Language: SSA will not disclose the records unless applicable date ranges are included.

New Language: You must check at least one box. Also, we will not disclose records unless applicable date ranges are included.

Justification 3: We are making this change to further clarify the instructions and signify that an entry is required in this section.

Change 4: We are deleting the comma after the word “individual” in the perjury statement.

Old Language: I am the individual, to whom the requested information/record applies, or the parent or legal guardian of a minor, or the legal guardian of a legally incompetent adult.

New Language: I am the individual to whom the requested information/record applies, or the parent or legal guardian of a minor, or the legal guardian of a legally incompetent adult.

Justification 4: We are making this language change to grammatically correct the sentence.