Addendum to Supporting Statement 0960-0267

Addendum - 0267 (Final).docx

Medicaid Use Report

Addendum to Supporting Statement 0960-0267

OMB: 0960-0267

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Addendum to Supporting Statement for Medicaid Use Report

20 CFR 416.268

OMB 0960-0267



Minor Revisions to the Collection Instruments


SSA is making the following revisions:


  • Change #1: We are revising the PRA statements on this collection.


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  The current language, which dates back to the last reprint of the form, is now outdated.


  • Change #2: We are revising the Privacy Act Statements on this collection.


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 this collection.

File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
File TitleAddendum to the Supporting Statement for Form SSA-3462
Author177717
File Modified0000-00-00
File Created2024-07-24

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