Addendum to Supporting Staement

Addendum to the Supporting Statement for Form SSA‑L725,

Letter to Employer Requesting Information About Wages Earned by Beneficiary

20 CFR 404.1520, 20 CFR 404.1571-404.1576, 20 CFR 404.1584-404.1593,

20 CFR 416.971-416.976

OMB No. 0960-0034

Revision to the Collection Instrument

We are seeking OMB approval for the following revisions to Form SSA-L725:

• Change #1: Add this language to the request letter: “A computerized printout in any format may be substituted for the enclosed form.”

Justification #1: This statement imposes less of a burden on employers by allowing them to respond in a format that is convenient for them.

• Change #2: Add the start date and stop dates of employment.

Justification #2: This will allow SSA to accurately record work months. The employer may list that the employee is currently employed. This alerts SSA to develop future earnings. There may months that there are no earnings for an individual, yet the employer indicates that the beneficiary was employed during that time. This would alert SSA to develop for unsuccessful work attempts.

• Change #3: We are adding a Privacy Act Statement.

Justification #3: SSA’s Office of the General Counsel (OGC) is conducting a systematic review of SSA’s Privacy Act Statements on agency forms. We are adding a Privacy Act Statement to this form per our OGC’s recommendation.

Since SSA maintains Form SSA-L725 as an electronic form which we pre-fill and send to the employers, we do not keep printed stock. Upon OMB approval of these revisions, SSA will make the previous version obsolete, and use only the OMB-approved, revised version of the form.