Addendum to the Supporting Statement 0960-0104

Addendum to the Supporting Statement for Form SSA-1560

Petition for Authorization to Charge and Collect a Fee for Services Before the Social Security Administration

20 CFR 404.1720 – 404.1730, and 416.1520 – 416.1530

OMB No. 0960-0104

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  The current language, which dates back to the last reprint of the form, is now outdated.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.