Addendum to the Supporting Statement for 0960-0072

Addendum to the Supporting Statement for Form SSA-454-BK

Request for Reconsideration – Disability Cessation

20 CFR 404.909 and 416.1409

OMB # 0960-0072

Revisions to the Collection Instrument

SSA is making the following revisions:

• Change 1: We are revising the Privacy Act Statement for this form. (See Information Collection Attachment in ROCIS).

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 first page of the form.

• Change 2: We added a question to Section 1 and numbered it 1D.

Justification 2: Users request form to follow the same format as EDCS.

• Change 3: We moved question 1F to question 1H.

Justification 3: Users request form to follow the same format as EDCS.

• Change 4: We renumbered Section 1 so they are in numerical order.

Justification 4: Users request form to follow the same format as EDCS.

We are using the prior edition of the SSA-454-BK until the supply runs out and then switch to the revised version, since we are only changing the order of the questions to follow the format of EDCS.