Addendum to Supporting Statement for Form SSA-769
Request for Change in Time/Place of Disability Hearing
20 CFR 404.914 (c)(2) and 416.1414 (c)(2)
OMB No. 0960-0348
Minor Revisions to the Collection Instrument
SSA is making the following revisions:
Change #1: We are revising the PRA statement 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 The current language, which dates back to the last reprint of the form, is now outdated.
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 form.
| 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 | 2021-01-20 |