Certification of Low Birth Weight for SSI Eligibility (SSA-3830)
OMB No. 0960-0720
Revisions to the Collection Instrument
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.
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 The current language, which dates back to the last reprint of the form, is now outdated.
| File Type | application/msword |
| Author | 826655 |
| Last Modified By | 889123 |
| File Modified | 2012-02-27 |
| File Created | 2012-01-19 |