Addendum to the Supporting Statement 0960-0470

Addendum to the Supporting Statement for

Form SSA-L4163

Agency/Employer Government Pension Offset Questionnaire

20 CFR 404.408(a)

OMB No. 0960-0470

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  The current language, which dates back to the last reprint of the form, is now outdated.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