Addendum to Supporting Statement for Form SSA-58
Modified Benefit Formula Questionnaire-Employer
20 CFR 404.1512-404.1515, 416.912-416.915
OMB No. 0960-0477
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 The current language, which dates back to the last reprint of the form, is now outdated.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 first page of the form.
| File Type | application/msword |
| File Title | Addendum to the Supporting Statement for Form SSA-3462 |
| Author | 177717 |
| Last Modified By | 889123 |
| File Modified | 2010-11-04 |
| File Created | 2010-11-04 |