Supporting Statement for Forms SSA-4814-F5 and SSA-4815-F6
Medical Report on Adult with Allegation of Human
Immunodeficiency Virus Infection;
Medical Report on Child with Allegation of Human
Immunodeficiency Virus Infection
20 CFR 416.933-416.934
OMB No. 0960-0500
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 Type | application/msword |
| File Modified | 0000-00-00 |
| File Created | 0000-00-00 |