Addendum to the 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, 416.207, 404.508, and 416.553

OMB No. 0960-0293


Minor Revisions to the Collection Instrument


SSA is making the following revisions:



Justification #1: We are revising the PRA statements to reflect our current boilerplate language.  The current language, which dates back to the last reprint of the form, is now outdated.



Justification #2: 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 this collection.