Addendum to Supporting Statement for Form SSA‑4641‑F4

Authorization for the Social Security Administration to Obtain

Account Records from a Financial Institution

20 CFR 416.200, 416.203, 404.508, and 416.553

OMB No. 0960-0293

Minor Revisions to the Collection Instrument

SSA is making the following revisions:

• Change #1: We are revising the Privacy Act Statements on Form SSA-4641-F4 and its Internet version, the e4641.

Justification #1: 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 Statements on the forms.