Addendum - 0633

Addendum to the Supporting Statement for Forms SSA-637 and SSA-639

Site Review Questionnaire for Volume and Fee-for-Service Payees and

Beneficiary Interview Form

20 CFR 404.2035, 404.2065, 416.665, 416.701, and 416.708

OMB No. 0960-0633

Minor Revisions to the Collection Instruments

SSA is making the following revisions:

• Change #1: We are revising the PRA statements on these forms.

Justification #1: We are revising the PRA statements to reflect our current boilerplate language.  The current language, which dates back to the last reprint of the forms, is now outdated.

• Change #2: We are revising the Privacy Act Statements on these forms.

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 Statements on these forms.