Addendum to the Supporting Statement for 0960-0289

Addendum - 0289 (Final).docx

Claimant's Medications

Addendum to the Supporting Statement for 0960-0289

OMB: 0960-0289

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Addendum to the Supporting Statement for Form HA-4632

Claimant’s Medications

20 CFR, 404.1512 and 416.912

OMB No. 0960-0289


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  The current language, which dates back to the last reprint of the form, is now outdated.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 Created2021-11-03

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