Addendum to the Supporting Statement for 0960-0481

Addendum - 0481.docx

Statement of Funds You Provided to Another, Statement of Funds You Received

Addendum to the Supporting Statement for 0960-0481

OMB: 0960-0481

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Addendum to the Supporting Statement for SSA-2854 & SSA-2855

Statement of Funds You Provided to Another and Statement of Funds You Received

20 CFR 416.1103(f)

OMB No. 0960-0481



Revisions to the Collection Instrument


We are revising the PRA statement to reflect our current boilerplate language because our current language is outdated.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.


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