Addendum to the Supporting Statement for Forms SSA-637 and SSA-639
Site Review Questionnaire for Volume and Fee-for-Service Payees, and
Beneficiary Interview Form
20 CFR 404.2035, 404.2065, 416.665, 416.701, and 416.708
OMB No. 0960-0633
Minor Revisions to the Collection Instrument
Change #1: We are revising the Paperwork Reduction Act Statement (PRA) on this form.
Justification #1: 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 The current language, which dates back to the last reprint of the form, is now outdated. See revised PRA Statement under the ICR.
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
| File Title | Addendum to the Supporting Statement for Form SSA-3462 |
| Author | 177717 |
| File Modified | 0000-00-00 |
| File Created | 2021-01-24 |