Addendum to the Supporting Statement 0960-0030

Addendum to the Supporting Statement for

Form SSA-7011-F4, Statement of Employer

20 CFR 404.801-404.803

OMB No. 0960-0030

Minor Revisions to the Collection Instrument

SSA is making the following revisions:

• Change 1: We are revising line 4:

  • Old Language: “Did you submit wage report Forms W-2 and W-3, or equivalent magnetic media reports.”

• New Language: “Did you submit wage report Forms W-2 and W-3, or equivalent electronic reports.”

• Justification 1: We are changing the language, because SSA no longer uses magnetic media reports, we use electronic reports.

• Change 2: We are revising the Privacy Act Statement on this form.

Justification 2: 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 first page of the form.