Addendum to Supporting Statement - 0689

Addendum - 0689.docx

Certification of Contents of Document(s) or Record(s)

Addendum to Supporting Statement - 0689

OMB: 0960-0689

Document [docx]
Download: docx | pdf

Addendum to Supporting Statement for Form SSA-704

Certification of Contents of Document(s) or Record(s)

20 CFR 404.707, 404.715, 404.716, 404.720, 404.721, 404.723,

404.725, 404.727, 404.728, 404.730, 404.731, 404.732, 404.733,

404.735, 404.1370, 404.1371, 408.202 and 408.216

OMB No. 0960-0689


Minor Revisions to the Collection Instrument


SSA is making the following revisions:


  • Change # 1: We are revising the language on the label “Birthday Age Shown” on Page 1, Section A.


Old Language: Birthday Age Shown

New Language: Birthday Age as Shown on Evidence


Justification #1: We are updating to clarify that Birthday Age on the evidence could differ than Age.


  • Change #2: We are revising the language on the label “Nature of Evidence” on page 1, Sections A, B, C and D,


Old Language: Nature of Evidence

New Language: Type of Evidence


Justification #2: We are updating the label to provide clarity.


  • Change #3: Page 1, Section A, we are updating the box “Other” (Relationship to Applicant”) in two places for this section and in one place in Section C.


Old Language: “Other” (Relationship to Applicant”)

New Language: Other (Please enter Relationship of Custodian to the Applicant)


Justification #3: We are updating the description for “Other” to provide clarity when the document is in neither the custody of the applicant nor record custodian.


  • Change #4: Page 1, Section B, we are replacing terms “husband” and “wife” with gender neutral terms.


Old Language: “husband” and “wife”

New Language: “spouse”


Justification #4: This will align with the gender-neutral terms used on our other SSA forms.


  • Change #5: Page 1, Section C, updating the label “Death.”


Old Language: Death

New Language: Death Certificate


Justification #5: We are updating the label to clarify that the evidence was in the form of a death certificate.


  • Change #6: Page 1, Section E, “Explanation of Record” Question # 2, we are reformatting the boxes and removing the box labelled ballpoint pen.


Justification #6: We are revising to align the boxes with the labels, and we are removing the box for ballpoint pen since we already have a box labelled “Ink.”


  • Change # 7: Page 2, Section G, Official Title section, we need to update the job titles as shown in the chart below.

Official Title

New Title/ Comments

Senior Claims Specialist

Claims Technical Expert

Claims Representative

Claims Specialist

Field Representative

Remove

Service Representative

Customer Service Representative

Data Review Technician

Remove

Quality Assurance Specialist

Quality Assurance Technician

State Record Custodian

Remove


Justification #7: We are updating the job titles to reflect the titles currently in use.


  • Change #8: We are revising the Privacy Act Statement on this form.


Justification #8: 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/vnd.openxmlformats-officedocument.wordprocessingml.document
File Modified0000-00-00
File Created0000-00-00

© 2024 OMB.report | Privacy Policy