Addendum - 0124

Addendum - 0124.docx

Statement of Income and Resources

Addendum - 0124

OMB: 0960-0124

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Addendum to Supporting Statement for Form SSA-8010-BK

Statement of Income and Resources

20 CFR 416.207, 416.301-310, 416.704, and 416.708

OMB No. 0960-0124



Minor Revisions to the Collection Instrument


SSA is making the following revisions:


  • 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/vnd.openxmlformats-officedocument.wordprocessingml.document
File TitleAddendum to the Supporting Statement for Form SSA-3462
Author177717
File Modified0000-00-00
File Created2021-01-23

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