Addendum - 0037

Addendum to the Supporting Statement for Form SSA-632-BK

Request for Waiver of Overpayment Recovery

20 CFR 404.506-404.512, 416.550-416.558, and 416.570

And Form SSA-634

Request for Change in Overpayment Recovery Rate

20 CFR 404.502 and 416.571

OMB No. 0960-0037

Minor Revisions to Form SSA-632-BK

SSA is making the following revisions:

• Change #1: We eliminated the questions from the current form in Section 2, Questions for the Representative Payee.

Justification #1: This change ensures respondents do not provide representative payee information that SSA technicians can obtain from our own records.

• Change #2: We eliminated the question from the current form in Section 3, If you are Responsible for a Family Member’s Responsibility or Another Individual’s Overpayment.

Justification #2: This change ensures respondents do not provide information about the individual liable for the overpayment. SSA technicians are responsible for making the determination.

• Change #3: We removed several questions from the current form in Section 4, Information About the overpayment. We renamed the section, which is now located in Section 2.

Justification #3: We removed questions from this section to ensure respondents do not provide information that technicians can obtain from our own records.

• Change #4: We removed Section 10, questions 24 and 25.

Justification #4: This section is not necessary to have on the SSA-632 form. We revised the language in question 25, to simplify the question. It is the responsibility of technicians to review the information on the form and make the appropriate waiver determination.

• Change #5: We are revising the PRA statement on this form.

Justification #5: 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  The current language, which dates back to the last reprint of the form, is now outdated.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 #6: We are revising the Privacy Act Statement on this form.

Justification #6: 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 this form.

Minor Revisions to Form SSA-634

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  The current language, which dates back to the last reprint of the form, is now outdated.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