Document
Addendum to Supporting Statement
ICR 202608-0960-010 · OMB 0960-0635 · Object 171860900.
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Document Metadata
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
|---|---|
| File Title | Addendum to Supporting Statement |
| Author | SSA Response |
| Last Modified By | Writer |
| File Modified | 2026-09-15 |
| File Created | 2026-09-25 |
| Conversion State | complete |
Extracted Text
Addendum to the Supporting Statement for Form SSA-3380
Function Report – Adult
20 CFR 404.1512 and 20 CFR 416.912
OMB No. 0960-0635
Revisions to the Collection Instruments
Paper SSA-3380:
We are making the following revisions to the paper SSA-3380.
• Change #1: We are adding the following reminder instruction under the title for Section C: “If a specific activity is performed with the help of others, please indicate that.”
Justification #1: We are adding the reminder to the instructions to comply with the terms of clearance issued by OMB, which sought to remind the respondent of this initial instruction at questions on the form to which it is particularly relevant. These questions all fall within Section C.
Terms of Clearance
OMB placed the following Terms of Clearance on this Information Collection when they last approved it on 11/30/23:
• Term #1: The agency made clarifying changes to the description of the information collection, minor modifications to instructions on the form, and updated the burden estimate.
SSA response: SSA made clarifying changs to the description of the information collection, minor modifications to instructions on the form and updated the burden estimate. We have maintained these revisions in the submitted documentation.
• Term #2: Prior to resubmission to OMB, the agency is encouraged to add additional instructions under questions 9, 15, 16, and 17 to remind respondents to include discussion of activities where the claimant may require help from others in completing the relevant activity. If the agency declines to include additional instruction for these questions, it will schedule a meeting with OMB to discuss its decision prior to publishing the 60-day Federal Register notice.
SSA response: SSA met with OMB on 4/23/26 to discuss adding instructions under questions 9,15,16 and 17 to remind respondents to include discussion of activities where the claimant may require help from others in completing the relevant activities. During the meeting OMB agreed to allow SSA to add the instructions to Section C: “If a specific activity is performed with the help of others, please indicate that.”