Addendum to the Supporting Statement for Request for Evidence from Doctor (HA-66) and Evidence from Hospital (HA-67)
20 CFR 404 Subpart P and 20 CFR 416 Subpart I
Revisions to the Collection Instrument
SSA is making one revision to these forms:
Change #1: We are revising the Privacy Act Statement on this form.
Justification #1: 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 Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
| File Title | Addendum to the Supporting Statement for Form SSA-2528 |
| Author | Naomi Lebowitz |
| File Modified | 0000-00-00 |
| File Created | 2021-01-22 |