Addendum - 0577

Addendum - 0577.doc

Disability Report - Child

Addendum - 0577

OMB: 0960-0577

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Addendum to Supporting Statement for Form SSA-3820-BK

Disability Report-Child

20 CFR 416.912

OMB No. 0960-0577



Minor Revisions to the Collection Instrument


SSA is making the following revisions:


  • Change #1: We are revising the Privacy Act Statement on this form.


Justification #1: 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.

File Typeapplication/msword
File TitleAddendum to the Supporting Statement for Form SSA-3462
Author177717
Last Modified ByLowman, Eric
File Modified2016-10-12
File Created2016-10-12

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