Addendum - 0505

Addendum - 0505.doc

Employer Verification of Records for Children Under Age 7

Addendum - 0505

OMB: 0960-0505

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Addendum to Supporting Statement for Form SSA-L3231-C1

Employer Verification of Records for Children Under Age 7

20 CFR 404.801-404.803, 404.821-404.822

OMB No. 0960-0505



Minor Revisions to the Collection Instrument


SSA is making the following revisions:


  • Change #1: We are revising the PRA statement on this form.


Justification #1: 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  The current language, which dates back to the last reprint of the form, is now outdated.


  • Change #2: We are revising the Privacy Act Statement on this form.


Justification #2: 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 ByLowman, Eric
File Modified2016-02-23
File Created2016-02-23

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