Storing Consent Forms

Consent-Based Social Security Number Verification Service (CBSV)

OMB: 0960-0760

IC ID: 181574

Information Collection (IC) Details

View Information Collection (IC)

Storing Consent Forms
 
No Unchanged
 
Voluntary
 
20 CFR 401.100

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form SSA-89 Authorization for SSA to Release SSN Verification SSA-89 Revised Version.pdf No   Paper Only

Income Security General Retirement and Disability

 

90 0
   
Private Sector Businesses or other for-profits, Not-for-profit institutions
 
   0 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 22,590 0 0 0 0 22,590
Annual IC Time Burden (Hours) 22,590 0 0 0 0 22,590
Annual IC Cost Burden (Dollars) 27,000 0 0 0 0 27,000

Title Document Date Uploaded
SSA-89 Current Version SSA-89 Current Version.doc 08/07/2013
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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