Information Collection

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

IC 257878 under ICR 202406-0960-004 · 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⚠️ Notice: This information collection may be referencing outdated material.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-OP1 Consent for Disclosure of Records Protection Under the Privacy Act c. Consent for Release of Records (Electronic SSA-3288-OP1)+	Form and Instruction
SSA-3288-OP1 (revised).pdf	Other-Webform Application
SSA-3288-OP1 (revised).pdf	Other-Webform Application
SSA-3288-OP1 Consent for Disclosure of Records Protection Under the P SSA-3288-OP1 (Paper Version).pdf	Form and Instruction
SSA-3288-OP1 Consent for Disclosure of Records Protection Under the P SSA-3288-OP1 (Paper Version).pdf	Form and Instruction
SSA-3288-OP1 screens (current).pdf SSA-3288-OP1: (Webform Application) (current)	IC Document
SSA-3288-OP1 screens (current).pdf SSA-3288-OP1: (Webform Application) (current)	IC Document

IC Title:

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

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

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				www.ssa.gov/privacy	Yes	Yes	Fillable Fileable Signable
Form and Instruction	SSA-3288-OP1			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	Previously Approved
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
SSA-3288-OP1: (Webform Application) (current)		06/24/2024

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

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