Addendum to Supporting Statement for Forms:
SSA-L2765, Request for Self-Employment Information
SSA-L3365, Request for Employee Information
SSA-L4002 Request for Employer Information
20 CFR 422.120
OMB No. 0960-0508
On August 29, 2011, SSA suspended Form SSA-L4002 due to budgetary constraints. On January 12, 2013, we suspended Forms SSA-L3365 and SSA-L276 due to budgetary constraint. We will probably resume using Forms SSA-L2765, SSA-L3365, and SSA-L4002 in 2014.
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 The current language, which dates back to the last reprint of the form, is now outdated.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 | 2014-01-06 |
| File Created | 2014-01-06 |