Addendum to Supporting Staement

Addendum to the Supporting Statement - SSA-L725.docx

Letter to Employer Requesting Information About Wages Earned by Beneficiary

Addendum to Supporting Staement

OMB: 0960-0034

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Addendum to Supporting Statement for Letter to Employer Requesting Information

About Wages Earned By Beneficiary

Form SSA-L725

20 CFR 404.703, 20 CFR 404.801 & 20 CFR 404.820

OMB No. 0960-0034



Revision to the Collection Instrument


Change 1: We are replacing “SIGNATURE” with “NAME” at the bottom of pages 1 and 2.


Justification 1: We are making this change because there is no law or regulation that requires the respondent’s signature for form SSA-L725. We only need the name of the respondent’s representative who can verify monthly wages for a beneficiary.


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  The current language, which dates back to the last reprint of the form, is now outdated.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


We will begin using the new version of form SSA-L725 once we have depleted the old stock.

File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
AuthorSAB
File Modified0000-00-00
File Created2021-01-31

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