d. Consent of Release of Records - 20 CFR 401.100(a)&(b) - SSA-3288

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

⚠️ Notice: This information collection may be referencing outdated material.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
Form SSA-3288 d. Consent of Release of Records - 20 CFR 401.100(a)&(b) - SSA-3288 Form and Instruction
SSA-3288 Consent for Release of Information SSA-3288 - Revised Version.pdf Form and Instruction
SSA-3288 - Current Version.pdf Current SSA-3288 IC Document

Information Collection (IC) Details

IC Title:	d. Consent of Release of Records - 20 CFR 401.100(a)&(b) - SSA-3288	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(a) & (b)

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	SSA-3288	Consent for Release of Information	SSA-3288 - Revised Version.pdf		No		Fillable Printable

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 3,000,760	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Requested	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	3,000,760	760	3,000,000
Annual IC Time Burden (Hours)	150,038	38	150,000
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded
Current SSA-3288	SSA-3288 - Current Version.pdf	10/04/2019

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