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⚠️ Notice: This information collection may be referencing outdated material.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

Document Name Document Type
SSA-3288-OP1 (revised).pdf www.ssa.gov/privacy Other-Webform Application
SSA-3288-OP1 (revised).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
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

Information Collection (IC) Details

View Information Collection (IC)

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:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Webform Application			SSA-3288-OP1 (revised).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 %

	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

Title	Document	Date Uploaded
SSA-3288-OP1: (Webform Application) (current)	SSA-3288-OP1 screens (current).pdf	06/24/2024

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