OMB No. 0960-0269
Terms of Clearance
The agency made modifications to the Supporting Statement to provide additional clarity and to update burden estimations. The agency made modifications to the instructions (iClaims terms of service and paper forms) to provide improved guidance to respondents. Following the approval of this ICR, the agency will continue to consult with OMB about additional improvements to the instruments to improve burden reduction on this information collection, including identifying opportunities for funding requests related to improving the instruments.
At this time, SSA has not made additional modifications to reduce burden or identified funding opportunities for instrument enhancements. However; SSA plans to implement these improvements when funding becomes available, at that time we will consult with OMB.
Minor Revisions to the Collection Instrument
SSA is making the following revision:
HA-501-U5
Change #1: We are making the “Claimant Signature (Optional)” field is fillable like the rest of the PDF on this form.
Justification #1: We are revising this field on the form per OIRA request.
iAppeals Screens
Change #2: We are revising the language on iAppeals Screen Appd001-1 and Appd001-3,
Old Language: gender
New Language; sex
Justification #2: We are revising the language to comply with the Executive Order 14168, Defending Women from Gender Ideology Extremism and Restoring Biological Truth to the Federal Government.
Change #3: We are removing the following language: “Privacy and Security OMB No. 0960-0622, Privacy Policy, Privacy Act Statement, Accessibility Help” that located at the bottom of the Electronic Appeals Terms of Service (Tos0001) screen.
Justification #3: We are removing the language, because we already display this language on other where it’s applicable( e.g., Wlcm001, Appl001rec-1, Appl001rec-3, Scrn001, Entr001, etc.).
We will implement these revisions upon OMB’s approval. The revisions do not affect the public reporting burden for this application.
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
| File Title | Addendum to the Supporting Statement for Form SSA-3462 |
| Author | 177717 |
| File Modified | 0000-00-00 |
| File Created | 2025-05-20 |