Addendum to Supporting Statement for Form SSA-2490-BK,
Application for Benefits Under a U.S.
International Social Security Agreement
20 CFR 404.1925
OMB No. 0960-0448
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 The current language, which dates back to the last reprint of the form, is now outdated.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.
Change #3: We are increasing the burden for this information collection, as we are adding three new Totalization agreements.
Justification #3: The United States signed new agreements with Hungary on February 3, 2015; Brazil on June 30, 2015; and Iceland on September 27, 2016. SSA is including Hungary, Brazil and Iceland in this OMB renewal. The additional respondents from these three countries will increase the annual burden, as shown in #12 of the Supporting Statement, and explained in #15 of the Supporting Statement.
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
| File Title | Addendum to the Supporting Statement for Form SSA-3462 |
| Author | 177717 |
| File Modified | 0000-00-00 |
| File Created | 2021-01-22 |