Addendum to the Supporting Statement 0960-0784

Addendum to the Supporting Statement 0960-0784 (1-13-14).docx

Medicare Income-Related Monthly Adjustment Amount - Life-Changing Event

Addendum to the Supporting Statement 0960-0784

OMB: 0960-0784

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Addendum to the Supporting Statement for Form SSA-44

Medicare Income-Related Monthly

Adjustment Amount – Life-Changing Event

20 CFR 418.1205, .1255, .1265, .2205, .2255, .2265


OMB No. 0960-0784


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.

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