Addendum to Supporting Statement 0960-0444

Addendum - 0444 (Final).docx

Application for Supplemental Security Income

Addendum to Supporting Statement 0960-0444

OMB: 0960-0444

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Addendum to Supporting Statement for Form SSA-8001-BK

Application for Supplemental Security Income

20 CFR 416.305 - 20 CFR 416.335, Subpart C

OMB No. 0960-0444



Revisions to Form SSA-8001


  • Change #1: We are removing questions #2 and #6(a)-(c) that collect the claimant’s or child’s parent’s sex of male or female.


  • Justification #1: We are removing these questions, because we do not need this information to determine eligibility. SSI Claims uses Person information’s identity information table to collect information specific to the claimant (i.e., name, date of birth, and place of birth) when taking an SSI claim. The table includes a sex data field that technicians currently do not collect from the applicant when taking an SSI application.


  • Change #2: We are adjusting the question numbers starting with #2 - #33 and removed numbers 34-38 from the information provided with Part 8 - Important Information and the penalty clause and signature lines with Part 9 – Signatures.


Justification #2: We are making these revisions, because removing question #2 affected subsequent numbers for application questions. The numbers on the application are associated with application questions. Part 8 and Part 9 do not collect responses to application questions; therefore, we removed the numbers. These changes also reflects the format of our Title II applications.


Removal of the Preliminary Claim System (PCS)


  • Change #3: We are removing the reference to the PCS as a collection tool that we added with the March 2019 Change Request.


Justification #3: Due to reassessing IT Modernization initiatives, we stopped development for the PCS. SSA focus shifted to creating the Consolidated Claims Experience (CCE), which will replace our current legacy claim system with web-based claims.


These revisions do not affect the overall burden for this information collection. We will implement these revisions upon OMB’s approval.

File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
File TitleAddendum to the Supporting Statement for Form SSA-3462
Author177717
File Modified0000-00-00
File Created2022-06-08

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