Addendum to the Supporting Statement for
Forms SSA-4814 and SSA-4815
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
Revisions to the Collection Instrument
SSA is making the following revisions:
Change #1: We are revising the PRA statements on these forms.
Justification #1: We are revising the PRA statements to reflect our current boilerplate language. The current language, which dates back to the last reprint of the forms, is now outdated.
Change #2: We are revising the Privacy Act Statements on these forms.
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 Statements on these forms.
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
| File Title | Addendum to the Supporting Statement for Form SSA-3462 |
| Author | 177717 |
| File Modified | 0000-00-00 |
| File Created | 2022-09-03 |