Justification for Non-Substantive Changes for Forms SSA-4814-F5 and SSA-4815-F6
Medical Report on Adult with Allegation of Human
Immunodeficiency Virus Infection;
Medical Report on Child with Allegation of Human
Immunodeficiency Virus Infection
20 CFR, Subpart 416.933-.416.934
Justification for Non-Substantive Changes to the Collection or Resubmission of the Collection within One Year of OMB Approval
Change #1: We are revising the text on page 1 under “MEDICAL RELEASE INFORMATION on the SSA-4814-F5 and SSA-4815-F6.
Old Language: “Form SSA-827, "Authorization to Release Medical Information to the Social Security Administration," attached.”
New Language: “Form SSA-827, “Authorization to Disclose Information to the Social Security Administration (SSA),” attached.”
Justification 1: We are revising Forms SSA-4814-F5 and SSA-4815-F6, because the title of the SSA-827 has changed. We were unaware of the change in the title of the SSA-827 at the time of the previous submission of the clearance package. We believe having the correct title of the SSA-827 on these forms would be helpful to our respondents in knowing they have the correct SSA-827 for the purpose of completing these forms for our applicants.
| File Type | application/msword |
| Author | Paul J. Scott |
| Last Modified By | 889123 |
| File Modified | 2015-02-05 |
| File Created | 2015-02-05 |