Addendum to Supporting Statement 0960-0247

Addendum 0247.doc

Workers' Compensation/Public Disability Benefit Questionnaire

Addendum to Supporting Statement 0960-0247

OMB: 0960-0247

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Addendum to

Supporting Statement for Form SSA-546

Supplemental Security Income Claim Information Notice

OMB No. 0960-0247



Minor Revisions to the Collection Instrument


SSA is making the following revisions:


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. SSA is also revising the Paperwork Reduction Act statement to reflect updated contact information.


File Typeapplication/msword
File TitleAddendum to the Supporting Statement for Form SSA-3462
Author177717
Last Modified ByDebbie
File Modified2009-04-03
File Created2009-04-03

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