Application for Access to SSA Systems (SSA-120)

Justification for Non-substantive change (revised).doc

Application for Access to SSA Systems

Application for Access to SSA Systems (SSA-120)

OMB: 0960-0791

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Justification for Non-Substantive Change for Form SSA-120

Application for Access to SSA Systems

SSA-120

OMB No. 0960-0791


Revision to the Collection Instrument


Change: We are changing the INSTRUCTIONS FOR COMPLETING THE APPLICATION FOR ACCESS TO SSA- SYSTEMS (SSA-120) on page 4, Disposition of the Completed Form section, question 2.

  • Old Language: Office of Hearings and Appeals Regional and Field personnel – Send the form through the Security Officer in the OHA Regional Office to the Component Security Officer, 5107 Leesburg Pike, Falls Church, Virginia 22041-3255.


  • New Language: Office of Disability Adjudication and Review Regional and Field personnel – Send the form through the Security Officer in the ODAR Regional Office to the Component Security Officer, 5107 Leesburg Pike, Falls Church, Virginia 22041-3255.


Justification: We are making this change to reflect the Regional Office name change when sending the form.

We will start using the new version after OMB approval.


File Typeapplication/msword
Author889123
Last Modified By889123
File Modified2012-04-26
File Created2012-04-26

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