Document
Addendum to Supporting Statement 0960-0805
ICR 202608-0960-001 · OMB 0960-0805 · Object 171486100.
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Document Metadata
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
|---|---|
| File Title | Addendum to Supporting Statement 0960-0805 |
| Author | SSA Response |
| Last Modified By | Writer |
| File Modified | 2026-08-04 |
| File Created | 2026-08-28 |
| Conversion State | complete |
Extracted Text
Addendum to the Supporting Statement for Form SSA-3385
Report of Adult Functioning-Employer
20 CFR 404.1512 and 20 CFR 416.912
Form SSA-3385-BK
OMB No. 0960-0805
Revisions to the Collection Instruments
Paper SSA-3385:
We are making the following revisions to the paper SSA-3385.
• Change #1: We are revising the Privacy Act Statement on the form.
Justification #1: 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 Statement on the form.
Terms of Clearance
OMB placed the following Terms of Clearance on this Information Collection when they last approved it on 8/24/203:
• The agency modified Supporting Statement A to describe in additional detail the routine or common causes that trigger a DDS decision to send this form to a former employer, as well as how this collection relates to other elements of information collections used to develop an understanding of the claimant's residual functional capacity. The agency also updated the burden estimate.
SSA response: SSA complied with OMB’s request to modify the Supporting Statement A to describe in additional details the routine or common cause that triggers a DDS decision to send the SSA-3385 to a former employer, as well as how this collection relates to other elements of information collections used to develop an understanding of the claimant’s residual functional capacity. We also updated the burden estimate. We have maintained these revisions in the submitted documentation.