Information Collection

CPA Compliance Review and Report

IC 240660 under ICR 202507-0960-007 · OMB 0960-0817.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form eCBSV User Agreeme eCBSV User Agreement CPA Compliance Review and Report	Form and Instruction
Form eCBSV User Agreeme eCBSV User Agreement CPA Compliance Review and Report	Form and Instruction
Form SSA-89 Authorization for the Social Security Administration (SSA) to Release Social Security Number (SSN) Verification CPA Compliance Review and Report	Form and Instruction
Form SSA-89 Authorization for the Social Security Administration (SSA) to Release Social Security Number (SSN) Verification CPA Compliance Review and Report	Form and Instruction
eCBSV Customer Connection Screen Package.docx	Other-Internet Screens
eCBSV Customer Connection Screen Package.docx	Other-Internet Screens
eCBSV User Agreeme eCBSV User Agreement eCBSV User Agreement - Current Version (since 2025 Change Request).docx	Form and Instruction
eCBSV User Agreeme eCBSV User Agreement eCBSV User Agreement - Current Version (since 2025 Change Request).docx	Form and Instruction
SSA-89 Authorization for the Social Security Administration (SS SSA-89 - Current Version (since 2025 Change Request).pdf	Form and Instruction
SSA-89 Authorization for the Social Security Administration (SS SSA-89 - Current Version (since 2025 Change Request).pdf	Form and Instruction
eCBSV User Agreement - Previous Version (prior to the 2025 Change Request).docx Previous User Agreement (prior to the approved 2025 Change Request)	IC Document
eCBSV User Agreement - Previous Version (prior to the 2025 Change Request).docx Previous User Agreement (prior to the approved 2025 Change Request)	IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

CPA Compliance Review and Report

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.	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	eCBSV User Agreement	www.ssa.gov	Yes	Yes	Fillable Fileable Signable
Other-Internet Screens		www.ssa.gov	Yes	Yes	Fillable Fileable Signable
Form and Instruction	SSA-89	www.ssa.gov	Yes	Yes	Fillable Fileable Signable

Federal Enterprise Architecture Business Reference Module

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 21

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	21	21
Annual IC Time Burden (Hours)	1,680	1,680
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Previous User Agreement (prior to the approved 2025 Change Request)		03/23/2026

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

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