Addendum to the Supporting Statement for 0960-0050

Supporting Statement for Form SSA-7163

Questionnaire About Employment or Self-Employment Outside the United States

20 CFR 404.401(b)(l), 404.415 and 404.417

OMB Number 0960-0050

Terms of Clearance

The following Terms of Clearance were placed on the ICR for 0960-0050 on 7/3/07:

This ICR is approved as-is for one year only. Prior to next submission, SSA will solicit comment specifically about the need/utility of asking respondents to fill out their name twice in situations where the respondent is both the "worker" and the "employed beneficiary." SSA will also solicit comments on whether a check box that says "check here if the two are the same" will achieve the same results with even less burden on beneficiaries.

In response to the above, SSA solicited comments regarding the need of asking respondents to fill out their name twice in situations where the respondent is both the “worker” and the “employed beneficiary,” is making the following revisions to the SSA-7163:

Revision to the Collection Instrument

SSA is proposing to add the parenthetical statement “(If different from worker listed above)” in two places within the first section of the form. The above statement will be added next to the words “Name of Employed or Self-Employed Beneficiary” as well as in the box to the right of that where it states “Beneficiary’s Social Security Number.”

In adding this parenthetical statement, we believe that we achieve the same results with less of a burden on the beneficiaries.