Addendum to the Supporting Statement for 0960-0542

Addendum - 0542.doc

Function Report - Child (Birth to 1st Birthday, Age 1 to 3rd Birthday, Age 3 to 6th Birthday, Age 6 to 12th Birthday, Age 12 to 18th Birthday), 20 CFR 416.912 and 416.924a(a)(2)

Addendum to the Supporting Statement for 0960-0542

OMB: 0960-0542

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Addendum to the Supporting Statement for Function Reports – Child

Forms SSA-3375, 3376, 3377, 3378, and 3379

20 CFR 416.912 and 416.924a(a)(2)

OMB No. 0960-0542


Revisions to the Collection Instrument


We are revising the Paperwork Reduction Act 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 The current language, which dates back to the last reprint of the form, is now outdated.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 Statements on agency forms. As a result, SSA is updating the Privacy Act Statement on this form.

File Typeapplication/msword
File TitleAddendum to the Supporting Statement for Form SSA-2528
AuthorNaomi Lebowitz
Last Modified By889123
File Modified2010-08-04
File Created2010-08-04

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