Addendum to Supporting Statement 0546

Addendum 0546.doc

SSI Notice of Interim Assistance Reimbursement (IAR)

Addendum to Supporting Statement 0546

OMB: 0960-0546

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Supporting Statement for Form SSA-L8125-F6 and the Electronic Interim Assistance Reimbursement (IAR) Process

20 CFR 416.1901, .1902, .1904, .1906, .1908, .1910, .1920, .1922

OMB Control No. 0960-0546



Minor Revisions to the Collection Instrument


SSA is making the following revisions:


  • Change #1: We are revising the PRA statement on this form.


Justification #1: We are revising the PRA statement to reflect our current boilerplate language.  The current language, which dates back to the last reprint of the form, is now outdated.


  • Change #2: We are revising the Privacy Act Statement on this form.


Justification #2: 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.

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File Typeapplication/msword
File TitleAddendum to the Supporting Statement for Form SSA-3462
Author177717
Last Modified BySYSTEM
File Modified2017-08-02
File Created2017-08-02

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