Addendum to Supporting Statement for 0960-0777

Addendum to the Supporting Statement for

Request for Accommodation in Communication Method

Form SSA-9000-F6

45 CFR 85.51

OMB No. 0960-0777

Revisions to the Collection Instrument

• SSA is removing the burden for the paper form as none of the respondents used the paper form to request accommodation. Rather, all the requests we received from 2010 through 2012 were through either in-person or telephone interview. Therefore, while we will keep the paper form on file in case a respondent chooses to use it, we are removing the burden information for the paper form from this information collection request.

• Since the respondents have not used the paper version of the form, we are also removing the cover letter, SSA-L9000, as it is not necessary for the in-person or telephone interview process. We initially created the cover letter so we could send the paper version to respondents who request it; however, as mentioned in the Supporting Statement and in the first bullet above, since implementing the SSA-9000, we have not received any requests for the paper form.

• 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 The current language, which dates back to the last reprint of the form, is now outdated.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 Statement on agency forms. As a result, SSA is adding a Privacy Act Statement to this form.