Addendum - 0710

Addendum to the Supporting Statement for the HA-85, HA-86, and Regulations

Request to Withdraw a Hearing Request; Request to Withdraw an Appeals Council Request for Review; and Administrative Review Process for

Adjudicating Initial Disability Claims

20 CFR Parts 404, 405, and 416

OMB No. 0960-0710

Revision to the Collection Instrument:

SSA is making the following revisions:

• Change #1: We are revising the Privacy Act Statement on these forms.

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 these forms.

• Change #2: We removed "Office of Adjudication and Review" from the header of the HA-85 and HA-86.

Justification #2: The name of office has changed, and we chose just to remove it from the forms.