Addendum to Supporting Statement for Form SSA-4178

Addendum on PAS.doc

Marital Relationship Questionnaire

Addendum to Supporting Statement for Form SSA-4178

OMB: 0960-0460

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Addendum to

Supporting Statement for SSA-4178

Marital Relationship Questionnaire

20 CFR 416.1826

OMB No. 0960-0460



Minor Revisions to the Collection Instrument


SSA is making one revision:


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.


File Typeapplication/msword
File TitleAddendum to the Supporting Statement for Form SSA-3462
Author177717
Last Modified ByDebbie
File Modified2009-01-08
File Created2009-01-08

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