Addendum to Supporting Statement - 0766

Addendum to Supporting Statement for Form SSA-L707

Request for Proof(s) from Custodian of Records

20 CFR 404.703, 404.704, 404.720, 404.721, 404.723, 404.725, 404.728

OMB No. 0960-0766

Minor Revisions to the Collection Instrument

SSA is making the following revisions:

• Change #1: We are adding a “Date of Birth” line to the “Death Record” section on page 2.

Justification #1: This will assist the custodian of the record in finding the correct person and would be more consistent with the Marriage and Divorce sections of the form.

• Change #2: We are adding a space after the language “please indicate years” under the heading “Death Record” on page 2.

Justification #2: Adding a space will specify where to write the years and where to sign, thus insuring that the custodian of the record includes both of the requested items.

• Change #3: We are removing the terms “Bride” and “Groom” under heading “Marriage Record” on page 2.

Justification #3: We are removing these terms to be consistent with gender-neutral policy. This aligns with the gender-neutral terms used on our other SSA forms.

• Change #4: We are adding a space after the language “please indicate years” under heading “Marriage Record” on page 2.

Justification #4: Adding a space will specify where to write the years and where to sign, thus insuring that the custodian of the record includes both of the requested items.

• Change #5: We are adding a space after the language “please indicate years” under heading “Divorce Record” on page 2.

Justification #5: Adding a space will specify where to write the years and where to sign, thus insuring that the custodian of the record includes both of the requested items.

• Change #6: We are removing the terms “Husband” and “Wife” on page 2, under heading “Divorce Record.”

Justification #6: We are removing these terms and replacing with the term “spouse” to be consistent with gender-neutral policy. This aligns with the gender-neutral terms used on our other SSA forms.

• Change #7: SSA intends to provide Form SSA-L707 in a fillable PDF file in place of the non-fillable PDF version we currently provide. We propose to make all form entries fillable.

Justification #7: This change will allow the respondents to continue to print and complete the form by hand, or, alternatively, complete the form using a computing device, such as a personal computer or handheld (mobile) device, print for processing.

• Change #8: We are revising the PRA statement on this form.

Justification #8: 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 #9: We are revising the Privacy Act Statement on this form.

Justification #9: 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.

SSA will implement these changes upon OMB approval.