Addendum to Supporting Statement for 0960-0088

Addendum - 0088.doc

Student Reporting Form

Addendum to Supporting Statement for 0960-0088

OMB: 0960-0088

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Addendum for Forms SSA-1383 and SSA-1383-FC,

Student Reporting Form

20 CFR 404.352 (b)(2), 404.367, 404.368, 404.415, 404.434, 422.135

OMB No. 0960-0088


Revision to the Collection Instrument


  • Change #1: We are revising question #9 on the domestic SSA-1383 to reflect current policy and procedure. We are adding another question to the SSA-1383-FC. The new question #9 asks the student completing the form about the existence of any unsatisfied warrants for his or her arrest. Page 2 of the form includes updates to the How to Report, What to Report, and Failure to Report fields to mirror the domestic SSA-1383.


Justification #1: We are making these changes to the form at the request of the SSA’s Office of the General Counsel (OGC).


  • Change #2: We are revising the PRA Statement to reflect our current boilerplate language.


Justification #2: The current language, which dates back to the last reprint of the form, is now outdated.


  • Change #3: SSA is revising the Privacy Act (PA) Statement for this form.


Justification #3: SSA’s OGC is conducting a systematic review of the PA Statements on agency forms, and created a new PA Statement for this one.


Upon OMB’s approval, we plan to destroy the stock of the old version so we can begin using the new version of the form immediately.

File Typeapplication/msword
Author826655
Last Modified By889123
File Modified2014-03-21
File Created2013-12-27

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