Addendum to Supporting Statement for Forms SSA-4814-F5 and SSA-4815-F6
Medical Report on Adult with Allegation of Human
Immunodeficiency Virus Infection;
Medical Report on Child with Allegation of Human
Immunodeficiency Virus Infection
20 CFR, Subpart 416.933-.416.934
OMB No. 0960-0500
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 The current language, which dates back to the last reprint of the form, is now outdated.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 first page of the form.
| File Type | application/msword |
| File Title | Addendum to the Supporting Statement for Form SSA-3462 |
| Author | 177717 |
| Last Modified By | 889123 |
| File Modified | 2011-10-21 |
| File Created | 2011-10-21 |