Addendum to Supporting Statement for Form SSA-21
Modified Benefit Formula Questionnaire
OMB No. 0960-0051
Minor Revision to the Collection Instrument
Change #1: We are revising the Privacy Act Statement on this collection
Justification #1: SSA’s Office of Law and Policy 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 this collection.
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
| Author | White, April M. |
| File Modified | 0000-00-00 |
| File Created | 2025-07-01 |