Privacy and Disclosure of Official Records and Information; Availability of Information and Records to the Public

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form SSA-3288 Consent for Release of Information	Form and Instruction	Modified	Available
Form SSA-3288 b. Consent of Release of Records - 20 CFR 401.100(a)&(b) - SSA-3288	Form and Instruction	Modified	Repair queued
Form SSA-3288-OP1 Consent for Disclosure of Records Protection Under the Privacy Act	Form and Instruction	New	Available
Addendum - 0566.docx	Supplementary Document	Uploaded 2023-01-11	Missing upstream
Supporting Statement - 0566.docx	Supporting Statement A	Uploaded 2023-01-11	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
45122	e. FOIA Requests for Records - 20 CFR 402.130		Removed
45121	b. Consent of Release of Records - 20 CFR 401.100(a)&(b) - SSA-3288	Form and Instruction	Modified	Consent for Release of Information
45121	b. Consent of Release of Records - 20 CFR 401.100(a)&(b) - SSA-3288	Form and Instruction	Modified
45120	a. Amendment of Records - 20 CFR 401.65(a)		Modified
45119	b. Designating a Representative For Disclosure - 401.55(b)		Removed
38034	a. Access to Records - 20 CFR 401.40(b)&(c) & 401.45		Removed
257878	c. Consent for Release of Records (Electronic SSA-3288-OP1)+	Form and Instruction	New	Consent for Disclosure of Records Protection Under the Privacy Act
257878	c. Consent for Release of Records (Electronic SSA-3288-OP1)+	Other-Webform Application	New
213569	f. Respondents who request access to an extract of their SSN record	Other-SSN Printout	Removed

ICR Details

OMB Control No: 0960-0566	ICR Reference No: 202301-0960-001
Status: Historical Active	Previous ICR Reference No: 201905-0960-005
Agency/Subagency: SSA	Agency Tracking No:
Title: Privacy and Disclosure of Official Records and Information; Availability of Information and Records to the Public
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 04/14/2023
Retrieve Notice of Action (NOA)	Date Received in OIRA: 01/11/2023
Terms of Clearance: The agency made clarifications to its supporting statement to describe the various instruments under the ICR as well as future enhancements. The web-based instrument is approved consistent with the agency’s assertion of this instrument’s compliance with Pub. L. No. 116-50 ("Creating Advanced Streamlined Electronic Services for Constituents Act of 2019’’) and relevant guidance. The agency is encouraged to routinely review its standards to ensure ongoing consistency with P.L. 116-50 and other relevant statutes.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	04/30/2026	36 Months From Approved	05/31/2025
Responses	3,000,860	0	3,028,870
Time Burden (Hours)	2,954,216	0	159,139
Cost Burden (Dollars)	0	0	0

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Abstract: Under the Privacy and Disclosure of Official Records and Information regulations, SSA has established methods in which the public can consent to and authorize the release of records protected under the Privacy Act of 1974, 5 U.S.C. 552a of the United States Code, and request records accessible through the Freedom of Information Act (FOIA), 5 U.S.C. 552. Consent for Release of Records SSA obtains the required consent(s) (with certain exceptions specified by law) from anyone requesting information in SSA systems of records about another individual. We will not release information requested about an individual until we obtain the required consent from that individual. Under the Privacy Act of 1974 (5 U.S.C. 552a(b)), individuals may give SSA written consent to disclose their personal information to a third party of their choosing. In addition, individuals may have multiple needs for the disclosure of their personal information, such as for qualification for a mortgage or preemployment screenings. a. Form SSA-3288 (Consent for Release of Information): Form SSA-3288, is SSA’s preferred paper form for requests for disclosure of information based on the consent of the subject of the record. Respondents can download the SSA-3288 from ssa.gov/forms, obtain a copy at a local SSA field office, or request SSA mail a copy to them directly. Use of this form ensures compliance with SSA consent regulations at 20 CFR 401.100. SSA also collects consent on other writings, including non-SSA forms often used by large employers, that incorporate SSA-approved consent language. b. Form SSA-3288-OP1 (Consent for Disclosure of Records Protected Under the Privacy Act): The Form SSA-3288-OP1 will comply with the CASES Act, OMB M-21-04, and SSA consent regulations at 20 CFR 401.100. The CASES Act directed OMB to develop templates for, among other things, electronic consents for SSA to disclose records protected by the Privacy Act of 1974 to third parties. OMB implemented that statutory directive in memorandum M-21-04. SSA developed the SSA-3288-OP1 pursuant to the CASES Act and M-21-04. The public will access the webform application that populates Form SSA-3288-OP1 on the Internet by selecting the ‘‘Electronic Request for Consent to Disclose’’ link which will be posted at www.ssa.gov/privacy. The respondents are individuals consenting to, authorizing, and requesting SSA disclosure of records protected by the Privacy Act of 1974 to third parties.

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Authorizing Statute(s): US Code: 5 USC 552a Name of Law: The Privacy Act of 1974
   US Code: 5 USC 552 Name of Law: The Freedom of Information Act
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	87 FR 67531	11/08/2022
30-day Notice:	Federal Register Citation:	Citation Date:
	88 FR 1622	01/11/2023
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 3

table that charts list of burden

IC Title	Form No.	Form Name
a. Amendment of Records - 20 CFR 401.65(a)
a. Access to Records - 20 CFR 401.40(b)&(c) & 401.45
b. Designating a Representative For Disclosure - 401.55(b)
b. Consent of Release of Records - 20 CFR 401.100(a)&(b) - SSA-3288	SSA-3288	Consent for Release of Information
c. Consent for Release of Records (Electronic SSA-3288-OP1)+	SSA-3288-OP1	Consent for Disclosure of Records Protection Under the Privacy Act
e. FOIA Requests for Records - 20 CFR 402.130
f. Respondents who request access to an extract of their SSN record

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ICR Summary of Burden

table that charts list of burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	3,000,860	3,028,870	0	-18,010	-10,000	0
Annual Time Burden (Hours)	2,954,216	159,139	0	37,796	2,757,281	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: Yes

Burden Reduction Due to: Miscellaneous Actions

Short Statement: When we last cleared this IC in May 2022, the burden was 159,139. However, we are currently reporting a burden of 253,443 hours. This change stems from the following revisions: • An increase in the average burden per response (minutes) for Form SSA-3288, from 3 minutes to 5 minutes; • The addition of the new CASES Act compatible webform application, SSA-3288-OP1 which increases the public reporting burden, as our usability testing showed it takes an average of 10 minutes for respondents to read the instructions, gather the information, and complete the webform online. Which is five minutes more than the average burden for our paper SSA-3288. • The removal of the individual information collections (ICs) for Access to Records, Designating a Representative for Disclosure, FOIA Requests for Records, and Respondents Who Request Access to an Extract of their SSN Record. We removed these as we account for them under the IC for the SSA-3288 paper form. * Note: The total burden reflected in ROCIS is 2,954,216, while the burden cited in #12 of the Supporting Statement is 253,443. This discrepancy is because the ROCIS burden reflects the following components: field office waiting time + a rough estimate of a 30 minute, one-way, drive burden. In contrast, the chart in #12 of the Supporting Statement reflects actual burden.

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Annual Cost to Federal Government: $5,762,116

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     Yes

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     Yes

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? No

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 01/11/2023

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