Addendum to Supporting Statement - 0460

Addendum - 0460.docx

Marital Relationship Questionnaire

Addendum to Supporting Statement - 0460

OMB: 0960-0460

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Addendum to Supporting Statement for Form SSA-4178

Marital Relationship Questionnaire

20 CFR 416.1826

OMB No. 0960-0460



Minor Revisions to the Collection Instrument


SSA is making the following revision:


  • Change #1: We are revising the Privacy Act Statement on Form SSA-4178.


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 Form SSA-4178.

File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
File TitleAddendum to the Supporting Statement for Form SSA-3462
Author177717
File Modified0000-00-00
File Created2021-01-22

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