Addendum to Supporting Statement - 0689

Addendum - 0689.doc

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

Addendum to Supporting Statement - 0689

OMB: 0960-0689

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Addendum to 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 revision:


  • Change #1: We are revising the Privacy Act Statement on this form.


Justification #1: 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 form.

File Typeapplication/msword
File TitleAddendum to the Supporting Statement for Form SSA-3462
Author177717
Last Modified ByLowman, Eric
File Modified2016-04-25
File Created2016-04-25

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