Addendum to the Supporting Statement - 0960-0138

Addendum - 0138.docx

Letter to Employer Requesting Wage Information

Addendum to the Supporting Statement - 0960-0138

OMB: 0960-0138

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Addendum to the Supporting Statement for Form SSA-L4201

Letter to Employer Requesting Wage Information

OMB No. 0960-0138




Minor Revisions to the Collection Instrument


SSA is making the following revisions:


  • Change #1: SSA is updating the Privacy Act Statement of the form.


Justification #1: SSA’s Office of the General Counsel is conducting a systematic review of SSA’s Privacy Act Statements on agency forms. We are revising the Privacy Act Statements which require changes to remain in compliance.

File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
File TitleAddendum to the Supporting Statement for Form SSA-3462
Author177717
File Modified0000-00-00
File Created2021-01-26

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