Addendum to the Supporting Statement 0960-0696

Addendum to the Supporting Statement 0960-0696.docx

Application for Help with Medicare Prescription Drug Plan Costs

Addendum to the Supporting Statement 0960-0696

OMB: 0960-0696

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Addendum to the Supporting Statement for

Form SSA-1020/i1020

Application for Extra Help with

Medicare Prescription Drug Plan Costs


OMB No. 0960-0696


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 collection instrument.

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