Addendum - 0448

Addendum to Supporting Statement for Form SSA-2490-BK

Application for Benefits Under a U.S.

International Social Security Agreement

20 CFR 404.1925

OMB No. 0960-0448

Minor Revisions to the Collection Instrument

SSA is making the following revisions to the SSA-2490-BK:

• Change #1: Page 1 - Question 2(b) and Page 2 - Question 2(b), we are replacing “which” with “that”.
  
  Justification #1: We made this change to be grammatically correct.

• Change #2: Page 3, Questions 3, we removed the following words from the sentence: “all” and “for which I am eligible”.
  

Justification #2: This edit makes the question clearer allowing beneficiaries to restrict the scope to a particular class of benefits listed in the check boxes.

• Change #3: Page 3, Question 4, we moved the text in question 4 (d) directly under questions 4 (b) and 4(c).
  
  

Justification #3: This edit makes the question easier to respond to by the applicant.

• Change #4: Page 3, Question 6, we made the letter “s” in the words "social security," lower case.
  
  

Justification #4: We made this change to be grammatically correct since it is not referring to the U.S. Social Security.

• Change #5: Page 4, Question 14, in the parenthetical phrase deleted “U.S.”, capitalized “Reserve”, and inserted “active duty”.
  
  

Justification #5: We changed this in order to clarify the U.S. military activity information SSA wants to collect in that question.

• Change #6: We are revising the PRA statement on this form.

Justification #6: 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  The current language, which dates back to the last reprint of the form, is now outdated.