Addendum to the Supporting Statement for Forms
SSA-5062, Claimant Statement about Loan of Food or Shelter and
SSA-L5063-F3, Statement about Food or Shelter Provided to Another
20 CFR 416.1130-1148
OMB No. 0960-0529
Minor Revisions to the Collection Instrument
SSA is making the following revisions:
Change #1: We are revising the Privacy Act Statement on this form.
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 form.
| File Type | application/msword |
| File Title | Addendum to the Supporting Statement for Form SSA-3462 |
| Author | 177717 |
| Last Modified By | SYSTEM |
| File Modified | 2018-08-08 |
| File Created | 2018-08-08 |