Addendum to the Supporting Statment 0960-0689

Addendum 0960-0689.doc

Certification of Contents of Document(s) or Record(s)

Addendum to the Supporting Statment 0960-0689

OMB: 0960-0689

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Addendum to the Supporting Statement for Form SSA-704

Certification of Contents of Document(s) or Record(s)

20 CFR 404.707, 404.715, 404.716, 404.720, 404.721,

404.723, 404.725, 404.727, 404.728, 404.730, 404.731, 404.732,

404.733, 404.735, 404.1370, 404.1371, 408.202 and 408.216


OMB No. 0960-0689




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  The current language, which dates back to the last reprint of the form, is now outdated.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-3462
Author177717
Last Modified By889123
File Modified2013-01-04
File Created2013-01-04

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