Addendum to Supporting Statement 0665

Addendum to the Supporting Statement for SSA-711

Request for Deceased Individual’s Social Security Record

20 CFR 402.130

OMB No. 0960-0665

Revision to the Collection Instrument

We are making the following revisions to the SSA-711 both to correct typographical errors, and changes in fees:

• Change #1 (Page 1): Under the second bullet, we are revising:

• We would like to change both $21.00 to $24.00

• We would like to change both $27.00 to $22.00

Justification #1: The fees for the form generally change every couple years.

• Change #2 (Page 2): We are revising the number on the form, changing Section “8” to “7” and Section “9” to “8.”

Justification #2: The numbering on the form is incorrect, as it skips from Section 6 to Section 8. Therefore, we wish to correct this typographical error.

• Change #3: We are revising the Privacy Act Statement on this form.

Justification #3: 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.