Addendum to Supporting Statement for Form SSA-8019-U2
Third Party Liability Information Statement
42 CFR 433.136-433.139
OMB No. 0960-0323
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 The current language, which dates back to the last reprint of the form, is now outdated.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 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 | 2015-07-08 |
| File Created | 2015-07-08 |