CPA Compliance Review and Report

Electronic Consent Based Social Security Number Verification

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0960-0817 can be found here:

Documents and Forms

Document Name Document Type
Form eCBSV User Agreeme CPA Compliance Review and Report Form and Instruction
eCBSV FRN Webpage Language (02-01-2021).docx www.ssa.gov Other-eCBSV Webpage Content
eCBSV FRN Webpage Language (02-01-2021).docx www.ssa.gov Other-eCBSV Webpage Content
eCBSV Screen Package.docx www.ssa.gov Other-Internet Screens
eCBSV Screen Package.docx www.ssa.gov Other-Internet Screens
eCBSV User Agreeme eCBSV User Agreement eCBSV User Agreement (6-7-21) - Clean Copy.docx www.ssa.gov Form and Instruction
eCBSV User Agreeme eCBSV User Agreement eCBSV User Agreement (6-7-21) - Clean Copy.docx www.ssa.gov Form and Instruction
eCBSV User Agreement - Current.pdf Current User Agreement IC Document
eCBSV User Agreement - Current.pdf Current User Agreement IC Document
eCBSV User Agreement (6-7-21) - Track Changes.docx eCBSV Revised User Agreement - Track Changes IC Document
eCBSV User Agreement (6-7-21) - Track Changes.docx eCBSV Revised User Agreement - Track Changes IC Document

Information Collection (IC) Details

IC Title:	CPA Compliance Review and Report	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Unchanged

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 20 CFR 401.100

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	eCBSV User Agreement	eCBSV User Agreement	eCBSV User Agreement (6-7-21) - Clean Copy.docx	www.ssa.gov	Yes	Yes	Fillable Fileable Signable
Other-eCBSV Webpage Content			eCBSV FRN Webpage Language (02-01-2021).docx	www.ssa.gov	Yes	Yes	Fillable Fileable Signable
Other-Internet Screens			eCBSV Screen Package.docx	www.ssa.gov	Yes	Yes	Fillable Fileable Signable

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 113	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Previously Approved
Annual Number of Responses for this IC	113	113
Annual IC Time Burden (Hours)	9,040	9,040
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Current User Agreement	eCBSV User Agreement - Current.pdf	03/26/2021
eCBSV Revised User Agreement - Track Changes	eCBSV User Agreement (6-7-21) - Track Changes.docx	06/08/2021

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