Addendum to Supporting Statement for
Medicare Subsidy Quality Review Forms
Forms SSA-9301, -9302, -9303, -9304, -9308, -9310,
-9311, -9312, - 9313, -9314 -8510
OMB No. 0960-0707
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/vnd.openxmlformats-officedocument.wordprocessingml.document |
| File Title | Addendum to the Supporting Statement for Form SSA-3462 |
| Author | 177717 |
| File Modified | 0000-00-00 |
| File Created | 2021-02-04 |