Addendum to the Supporting Statement 0960-0579

Addendum to the Supporting Statement for the SSA-3368

Disability Report – Adult

20 CFR 404.1512 and 416.912

OMB No. 0960-0579

Revisions to the Collection Instrument

We plan to make the following change to the paper Form SSA-3368-BK within the first year after approval. We will use the prior paper version until stock is exhausted.

The SGA amount for the electronic versions (EDCS Internet 3368 and i3368) corresponds with the year work ended based on the information the applicant provides.

• Change 1:

We are changing the dollar amount in sections 4.E and 4.G to reflect the 2018 Non-Blind SGA amount of $1,180.

Justification 1:

We are making this change to reflect the 2018 Non-Blind Disabled Substantial Gainful Activity (SGA) amount as contained within 20 CFR 404.1571 through 404.1576 and 416.971 through 416.976.

• 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.