Information Collection

c. Consent for Release of Records (Electronic SSA-3288-OP1)+

IC 257878 under ICR 202301-0960-001 · 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⚠️ Notice: This information collection may be referencing outdated material.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
CASES - OMB Screen Package.pdf www.ssa.gov/privacy	Other-Webform Application
CASES - OMB Screen Package.pdf www.ssa.gov/privacy	Other-Webform Application
SSA-3288-OP1 Consent for Disclosure of Records Protection Under the P SSA-3288-OP1 (Paper Version).pdf www.ssa.gov/privacy	Form and Instruction
SSA-3288-OP1 Consent for Disclosure of Records Protection Under the P SSA-3288-OP1 (Paper Version).pdf www.ssa.gov/privacy	Form and Instruction

IC Title:

c. Consent for Release of Records (Electronic SSA-3288-OP1)+

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 20 CFR 401.100

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
Other-Webform Application			CASES - OMB Screen Package.pdf	www.ssa.gov/privacy	Yes	Yes	Fillable Fileable Signable
Form and Instruction	SSA-3288-OP1	Consent for Disclosure of Records Protection Under the Privacy Act	SSA-3288-OP1 (Paper Version).pdf	www.ssa.gov/privacy	Yes	No	Fillable Printable

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 40,341

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	40,341	40,341
Annual IC Time Burden (Hours)	43,030	43,030
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.