Addendum-0792 (final)

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Addendum to the Supporting Statement for Forms SSA-187 and SSA-188
Incoming and Outgoing Intergovernmental
Personnel Act Assignment Agreement
5 CFR 334
OMB No. 0960-0792

Revisions to the Collection Instruments

    • Change #1:  We are updating the contact information on page 1 and 14.

Current Language:

Within 30 days of the effective date of the assignment, one copy of this form must be sent to: 

Executive & Special Services Staff
Room 2510 Annex Building
6401 Security Boulevard
Baltimore, MD 21235
Attn: IPA

^DCHR ESSS at [email protected]. 

Please Return This Form to: Office of the Deputy Commissioner for Human Resources/Executive & Special Services Staff
Room 2510 Annex Building
6401 Security Boulevard
Baltimore, Maryland, 21235-6401
Attn: IPA Staff
Revised Language: 

Within 30 days of the effective date of the assignment, one copy of this form must be sent to or emailed to ^HR.CompBen.ExecSvcs.gov.

Executive & Special Services Staff
6th Floor, Altmeyer Building
6401 Security Boulevard
Baltimore, MD 21235
Attn: IPA

^[email protected]
Please Return This Form electronically to ^[email protected] or to: 
Human Resources/Executive & Special Services Staff
6th Floor, Altmeyer Building
6401 Security Boulevard
Baltimore, Maryland, 21235-6401
Attn: IPA Staff

Justification #1:  We are updating the contact information, because the office moved offices and the email address changed.    

    • Change #2:  We are updating the title of item 39 on pages 8 and 11.

Current Language:
39. Certification of Deputy Commissioner for Human Resources
Signature of Component Deputy Commissioner
Revised Language:
39. Certification of Chief Human Capital Officer
	Signature of Chief Human Capital Officer

Justification #2:  In effectuating a reorganization, the highest position in with Human Resources changed from Deputy Commissioner for Human Resources to Chief Human Capital Officer. 
    • Change #3:  We are removing language in item 6 on page 1.

Current Language:
6. Federal Agency/DC Office/Component that is party to the agreement.
Revised Language:
6. Federal Agency/Component that is party to the agreement.

Justification #3:  Since we reorganized, we no longer reference DC Offices.

    • Change #4:  We are updating the title of item 37 on pages 8, and 11.

Current Language:
37. Component Deputy Commissioner
	Signature of Component Deputy Commissioner
Revised Language:
37. Component Chief
	Signature of Component Chief

Justification #4:  Since we reorganized, the highest position in each component changed from Deputy Commissioner to Chief. 
    • Change #5:  We are updating the titles page 14.

Current Language:
Component Associate Commissioner’s Signature
Component Deputy Commissioner’s Signature
Revised Language:
Component Head’s Signature 
Component Chief’s Signature

Justification #5:  Since we reorganized, the highest position in each component changed from Deputy Commissioner to Chief and positions reporting to Chiefs are Heads. 
    • Change #6:  We are revising the Privacy Act Statement on this form.

Justification #6:  SSA’s Office of Law and Policy / Privacy & Disclosure Policy is conducting a systematic review of SSA’s Privacy Act Statements on agency forms.  As a result, SSA is updating the Privacy Act Statement on the form.

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

Note:  While the revised, mocked up versions of the forms attached to this revision request do not show the fillable fields, after OMB approval we will implement versions of the forms which are fully fillable and submittable.

Terms of Clearance
OMB placed the following Terms of Clearance on this Information Collection when they last approved it on 07/20/23:
    • Term #1:  The agency made minor changes to the supporting statement and updated the instrument to clarify that it can be fully electronically completed (including the signature field).

SSA response:  SSA complied with OMB’s request to make minor changes to the supporting statement and updated the instrument to clarify that it can be fully electronically completed, including the signature field.  We have maintained these revisions in the submitted documentation.