Request for Social Security Statement Form SSA-7004

Justification for Non-Substantive Change for SSA-7004

Request for Social Security Statement

20 CFR 404.810

OMB No. 0960-0466

Revisions to the Collection Instrument

We are making the following changes to Form SSA-7004

Change 1: We are revising the language on page one of the form

• Old language:

We hope you will find the Statement useful in planning your financial future. Remember, Social Security is more than a program for retired people. It helps people of all ages in many ways. For example, it can help support your family in the event of your death and pay you benefits if you become severely disabled.

• New Language:

We hope you will find the Statement useful in planning your financial future. Remember, Social Security is more than a program for retired people. It helps people of all ages in many ways. For example, it can help support your family when you die and pay you benefits if you become severely disabled.

Justification 1

We are changing the language to correspond with the language we use in other publications

Change 2: We are revising the language on page one of the form

• Old Language:

Please print or type your answers. When you have completed the form, fold it and mail it to us. If you prefer to send your request using the Internet, go to www.socialsecurity.gov.

• New Language:

Please print or type your answers. When you have completed the form, mail it to:

Justification 2:

We are changing the language, because people no longer send requests over the Internet.

Change 3: We are revising the Privacy Act Statement

Justification 3: Our edits to the Privacy Act Statement are consistent with the Privacy language we display on other recently reprinted forms, which are grammatically correct and improve the accuracy of the content.