Form SSA-88 Pre-Approval Form For Consent Based Social Security Numb

Form SSA-88 (04-2017)

Page 2 of 2

Privacy Act Statement
Collection and Use of Personal Information See Revised Privacy Act Note

and PRA Statement Attached
Sections 205(a) and 1106 of the Social Security Act, as amended, allow us to collect this information.
Furnishing us this information is voluntary. However, failing to provide all or part of the information may
prevent us from providing consent-based Social Security number verifications (CBSV) to your company.
We will use the information to register your company and authorized employees for CBSV use. In addition,
we may use the information for purposes authorized by law including to ensure the appropriate use of
CBSV.
Paperwork Reduction Act Statement - This information collection meets the requirements of 44 U.
S.C. § 3507, as amended by section 2 of the Paperwork Reduction Act of 1995 You do not need to
answer these questions unless we display a valid Office of Management and Budget control number. We
estimate that it will take about 3 minutes to complete the form. You may send comments on our time
estimate above to: SSA, 6401 Security Blvd., Baltimore, MD 21235-6401. Send to this address only
comments relating to our time estimate, not the completed form.

SSA will insert the following revised Privacy Act Notice and PRA Statement into
the form as soon as possible:
Privacy Act Notice
Collection and Use of Personal Information

Sections 205(a) and 1106 of the Social Security Act, as amended, allow us to collect this
information. Furnishing us this information is voluntary. However, failing to provide all or part
of the information may prevent us from providing Consent Based Social Security Number
Verification (CBSV) services to your company. We will use the information to register your
company and authorized employees for CBSV access. Additional information, and a full listing
of all of our System of Records Notices, is available on our website at www.ssa.gov/privacy.

Paperwork Reduction Act Statement - This information collection meets the requirements of
44 U.S.C. § 3507, as amended by section 2 of the Paperwork Reduction Act of 1995. You do not
need to answer these questions unless we display a valid Office of Management and Budget
(OMB) control number. We estimate that it will take about 20 minutes to read the instructions,
gather the facts, and answer the questions. Send only comments regarding this burden estimate
or any other aspect of this collection, including suggestions for reducing this burden to: SSA,
6401 Security Blvd, Baltimore, MD 21235-6401.