Addendum to Supporting Statement

Addendum - 0293.doc

Authorization for SSA to Obtain Account Records From A Financial Institution And Request For Records

Addendum to Supporting Statement

OMB: 0960-0293

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Addendum to the Supporting Statement for Form SSA‑4641‑U2

Authorization for the Social Security Administration to Obtain

Account Records from a Financial Institution

20 CFR 416.200 & 416.203

OMB No. 0960-0293


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  The current language, which dates back to the last reprint of the form, is now outdated.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.


File Typeapplication/msword
File TitleAddendum to the Supporting Statement for Form SSA 4641 U2
Author177717
Last Modified By889123
File Modified2012-11-01
File Created2012-11-01

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