Addendum to Supporting Statement for 0960-0395

Addendum - 0395.doc

Modified Benefit Formula Questionnaire

Addendum to Supporting Statement for 0960-0395

OMB: 0960-0395

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Addendum to the Supporting Statement for Form SSA-150

Modified Benefit Formula Questionnaire

OMB No. 0960-0395


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 the SSA-150. The current language, which dates back to the last reprint of the form, is now outdated.


File Typeapplication/msword
File TitleRevised item 11 SSA-8
Last Modified By889123
File Modified2014-03-21
File Created2014-02-10

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