Addendum to the Supporting Statement

Addendum to the Supporting Statement.doc

Self-Employment/Corporate Officer Questionnaire

Addendum to the Supporting Statement

OMB: 0960-0487

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Addendum to

Supporting Statement for Form SSA-4184

Self-Employment/Corporate Officer Questionnaire

OMB No. 0960-0487



Minor Revisions to the Collection Instrument


SSA is making the following revisions:


We are revising the PRA statement to reflect our current boilerplate language.  The current language, which dates back to the last reprint of the form, is now outdated.


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.


File Typeapplication/msword
File TitleAddendum to the Supporting Statement for Form SSA-3462
Author177717
Last Modified ByDebbie
File Modified2009-05-06
File Created2009-05-06

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