Addendum to the Supporting Statement for 0960-0061

Addendum - 0061.doc

Farm Self-Employment Questionnaire

Addendum to the Supporting Statement for 0960-0061

OMB: 0960-0061

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Addendum to the Supporting Statement for Form SSA-7156

Farm Self-Employment Questionnaire

20 CFR 404.1082(c) & 20 CFR 404.1095

OMB No. 0960-0061


Terms of Clearance


OMB approves this collection consistent with the complete supporting statement by SSA provided on 6/1/07.


As per the Terms of Clearance, SSA provided an updated Supporting Statement on 6/1/07 that better explained why we do not have an electronic version of the SSA-7156. Since the SSA-7156 is an agency-initiated form that SSA employees complete during face-to-face or telephone interviews with the respondents which falls under the threshold for the Government Paperwork Elimination Act, we have not scheduled the form for electronic implementation.

Revisions to the Collection Instrument


SSA is making the following revisions:


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 The current language, which dates back to the last reprint of the form, is now outdated.


  • SSA’s Office of the General Counsel is conducting a systematic review of SSA’s Privacy Act Statement on agency forms. As a result, SSA is adding a Privacy Act Statement to this form.

File Typeapplication/msword
File TitleAddendum to the Supporting Statement for Form SSA 4641 U2
Author177717
Last Modified By177717
File Modified2010-01-25
File Created2009-12-10

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