Addendum - 0034

Addendum - 0034 (Final).docx

Letter to Employer Requesting Information About Wages Earned by Beneficiary

Addendum - 0034

OMB: 0960-0034

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Addendum to the Supporting Statement for Form SSA‑L725

Letter to Employer Requesting Information About Wages Earned by Beneficiary

20 CFR 404.1520, 404.1571-404.1576, and 404.1584-404.1593

OMB No. 0960-0034


Minor Revisions to the Collection Instrument


SSA is making the following revisions:


  • Change #1: We are revising the PRA statement on the 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  The current language, which dates back to the last reprint of the form, is now outdated.


  • Change #2: We are revising the Privacy Act Statement on the form.


Justification #2: 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 Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
File TitleAddendum to the Supporting Statement for Form SSA-3462
Author177717
File Modified0000-00-00
File Created2021-03-03

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