Addendum to Supporting Statement

0576 addendum.doc

Representative Payee Report of Benefits and Dedicated Account

Addendum to Supporting Statement

OMB: 0960-0576

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Addendum to Supporting Statement

Representative Payee Report of Benefits and Dedicated Account SSA-6233

20 CFR 416.546, 416.635, 416.640, 416.665

OMB No. 0960-0576



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  The current language, which dates back to the last reprint of the form, is now outdated.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 ByOffice 2004 Test Drive User
File Modified2012-08-29
File Created2012-08-29

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