Addendum - 0499

Addendum - 0499.docx

Questionnaire for Children Claiming SSI Benefits

Addendum - 0499

OMB: 0960-0499

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Addendum to the Supporting Statement for Form SSA-3881-BK

Questionnaire for Children Claiming SSI Benefits

20 CFR 416.912(a)

OMB No. 0960-0499



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  The current language, which dates back to the last reprint of the form, is now outdated.

File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
File TitleAddendum to the Supporting Statement for Form SSA-3462
Author177717
File Modified0000-00-00
File Created2021-01-14

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