Information Collection

Consent of Release of Records

IC 45121 under ICR 200609-0960-004 · OMB 0960-0566.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0960-0566 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form SSA-3288 Consent of Release of Records	Form and Instruction
SSA-3288 Consent for Release of Information SSA-3288.pdf	Form and Instruction

IC Title:

Consent of Release of Records

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Voluntary

CFR Citation: 20 CFR 401.100(a) & (b)

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	SSA-3288	Consent for Release of Information	SSA-3288.pdf		No		Paper Only

Line of Business:

Subfunction:

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 3,000,000

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate
Annual Number of Responses for this IC	3,000,000	3,000,000
Annual IC Time Burden (Hours)	150,000	150,000
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.