ADDENDUM TO THE SUPPORTING STATEMENT

Addendum for Internet and Automated Telephone Request for Replacement Forms

SSA-1099/1042S

OMB No. 0960-0583

Minor Revisions to the Collection Instrument

Change 1: We are changing the title of the Supporting Statement.

• Old: Internet Request for Replacement Forms SSA-1099/1042S

• New: Internet and Automated Telephone Request for Replacement Forms SSA-

1099/1042S

Justification 1: We are changing the title to include the automated telephone request for replacement Forms SSA-1099/1042S.

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  The current language, which dates back to the last reprint of the form, is now outdated.

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 first page of the form