Addendum to the Supporting Statement for 0960-0665

Addendum - 0665.doc

Report of Deceased Individual's Social Security Record

Addendum to the Supporting Statement for 0960-0665

OMB: 0960-0665

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Addendum to the Supporting Statement for Form SSA-711

Request for Deceased Individual’s Social Security Record

20 CFR 402.130

OMB No. 0960-0665




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  The current language, which dates back to the last reprint of the form, is now outdated.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 Typeapplication/msword
File TitleAddendum to the Supporting Statement for Form SSA-3462
Author177717
Last Modified By889123
File Modified2012-10-03
File Created2012-10-03

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