Document

Addendum to Supporting Statement 0960-0069

ICR 201305-0960-002 · OMB 0960-0069 · Object 39601001.

This document may belong to an older filing. More recent activity for OMB 0960-0069:

Document Viewer [doc]

Status: Original and derived artifacts are available for this document.

Download: doc | pdf | html

Primary: htmlSource: application/msword

Loading document viewer…

Document Metadata

Record metadata
File Type	application/msword
File Title	Addendum to Supporting Statement 0960-0069
Author	889123
Last Modified By	Writer
File Modified	2013-05-09
File Created	2026-08-24
Conversion State	complete

Extracted Text

Addendum to the Supporting Statement for 
Form SSA-624
Representative Payee Evaluation Report
20 CFR 404.2065 and 416.665

OMB No. 0960-0069

Minor Revisions to the Collection Instrument

SSA is making the following revisions:

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 form.