Addendum to the Supporting Statement - 0776

Addendum - 0776.docx

Financial Disclosure for Civil Monetary Penalty (CMP) Debt

Addendum to the Supporting Statement - 0776

OMB: 0960-0776

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Addendum to the Supporting Statement for SSA-640
Financial Disclosure for Civil Monetary Penalty (CMP) Debt
20 CFR 498
OMB No. 0960-0776



Minor Revisions to the Collection Instrument


SSA is making the following revisions:


  • Change #1: SSA is updating the Privacy Act Statement on the form.


Justification #1: SSA’s Office of the General Counsel is conducting a systematic review of SSA’s Privacy Act Statements on agency forms. We are revising the Privacy Act Statements which require changes to remain in compliance.

File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
File TitleAddendum to the Supporting Statement for Form SSA-3462
Author177717
File Modified0000-00-00
File Created2021-01-21

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