Addendum - 0124

0124 Addendum.docx

Statement of Income and Resources

Addendum - 0124

OMB: 0960-0124

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Addendum to Supporting Statement for Form SSA-8010-BK

Statement of Income and Resources

20 CFR 416.207, 416.301-310, 416.704, and 416.708

OMB No. 0960-0124


Minor Revisions to the Collection Instrument


SSA is making the following revisions:


  • Change #1: We are revising the PRA statement on this form.


Justification #1: 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  The current language, which dates back to the last reprint of the form, is now outdated.



File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
File TitleAddendum to the Supporting Statement for Form SSA-3462
Author177717
File Modified0000-00-00
File Created2021-01-13

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