From: Subject: Paperwork Reduction Act Statement Date: Wed, 9 Dec 2009 14:26:27 -0500 MIME-Version: 1.0 Content-Type: multipart/related; type="text/html"; boundary="----=_NextPart_000_0043_01CA78DB.97C6A770" X-MimeOLE: Produced By Microsoft MimeOLE V6.00.2900.5579 This is a multi-part message in MIME format. ------=_NextPart_000_0043_01CA78DB.97C6A770 Content-Type: text/html; charset="iso-8859-1" Content-Transfer-Encoding: quoted-printable Content-Location: mhtml:file://C:\Documents and Settings\413980\Local Settings\Temporary Internet Files\OLK1E4\msg052 (2).mht Paperwork Reduction Act = Statement

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Paperwork Reduction Act=20 Statement

This information collection meets the = requirements of 44=20 U.S.C. 3507, as amended by section 2 of the Paperwork Reduction Act of = 1995. You=20 do not need to answer these questions unless we display a valid Office = of=20 Management and Budget (OMB) control number. The OMB control number for = this form=20 is 0960-0596; expiration date 09/30/2012. We estimate it will take about = 10=20 minutes to read the instructions, gather the facts, and answer the = questions.=20 You may send comments on our time estimate to SSA, 1338 Annex Building,=20 Baltimore, MD 21235-0001. Send only comments on our time = estimate to=20 this address, not the completed form.

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