View Information Collection Request (ICR) Package
Skip to main content
An official website of the United States government
The .gov means it's official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you're on a federal government site.
The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.
Search:
Agenda
Reg Review
ICR
This script is used to control the display of information in this page.
Display additional information by clicking on the following:
All
Brief and OIRA conclusion
Abstract/Justification
Legal Statutes
Rulemaking
FR Notices/Comments
IC List
Burden
Misc.
Common Form Info.
Certification
View Information Collection (IC) List
View Supporting Statement and Other Documents
Please note that the OMB number and expiration date may not have been determined when this Information Collection Request and associated Information Collection forms were submitted to OMB. The approved OMB number and expiration date may be found by clicking on the Notice of Action link below.
View ICR - OIRA Conclusion
OMB Control No:
0960-0566
ICR Reference No:
200609-0960-004
Status:
Historical Active
Previous ICR Reference No:
200603-0960-015
Agency/Subagency:
SSA
Agency Tracking No:
Title:
Privacy and Disclosure of Official Records and Information; Availability of Information and Records to the Public
Type of Information Collection:
Extension without change of a currently approved collection
Common Form ICR:
No
Type of Review Request:
Regular
OIRA Conclusion Action:
Approved without change
Conclusion Date:
12/11/2006
Retrieve Notice of Action (NOA)
Date Received in OIRA:
09/18/2006
Terms of Clearance:
Inventory as of this Action
Requested
Previously Approved
Expiration Date
12/31/2009
36 Months From Approved
12/31/2006
Responses
3,028,500
0
2,223,500
Time Burden (Hours)
159,133
0
111,175
Cost Burden (Dollars)
0
0
0
Abstract:
This information is required to identify individuals who request access to their records; designate an individual to receive and review their medical records; correct or amend records; obtain consent from an individual to release his/her records to others (consent is submitted by letter in writing or by use of the SSA-3288, or other consent form); and to facilitate the release of the information under the Freedom of Information Act. Respondents are individuals or businesses requesting access to, correction of, or disclosure of SSA records.
Authorizing Statute(s):
US Code:
5 USC 552
Name of Law: The Freedom of Information Act
US Code:
5 USC 552a
Name of Law: The Privacy Act of 1974
Citations for New Statutory Requirements:
None
Associated Rulemaking Information
RIN:
Stage of Rulemaking:
Federal Register Citation:
Date:
Not associated with rulemaking
Federal Register Notices & Comments
60-day Notice:
Federal Register Citation:
Citation Date:
71 FR 34181
06/13/2006
30-day Notice:
Federal Register Citation:
Citation Date:
71 FR 53485
09/11/2006
Did the Agency receive public comments on this ICR?
No
Number of Information Collection (IC) in this ICR:
6
IC Title
Form No.
Form Name
Access to Records
Amendment of Records
Consent of Release of Records
SSA-3288
Consent for Release of Information
Designating a Representative For Disclosure
FOIA Requests for Records
Waiver/Reduction of Fees
ICR Summary of Burden
Total Approved
Previously Approved
Change Due to New Statute
Change Due to Agency Discretion
Change Due to Adjustment in Estimate
Change Due to Potential Violation of the PRA
Annual Number of Responses
3,028,500
2,223,500
0
0
805,000
0
Annual Time Burden (Hours)
159,133
111,175
0
0
47,958
0
Annual Cost Burden (Dollars)
0
0
0
0
0
0
Burden increases because of Program Change due to Agency Discretion:
No
Burden Increase Due to:
Burden decreases because of Program Change due to Agency Discretion:
No
Burden Reduction Due to:
Short Statement:
The increase in the public reporting burden from 111,175 to 195,133 is due to an increase in third party consents for verification and release of information.
Annual Cost to Federal Government:
$1,120,000
Does this IC contain surveys, censuses, or employ statistical methods?
No
Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002?
No
Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]?
Uncollected
Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]?
Uncollected
Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)?
Uncollected
Is this ICR related to the Pandemic Response?
Uncollected
Agency Contact:
Elizabeth Davidson 411-965-0454 liz.davidson@ssa.gov
Common Form ICR:
No
On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
(a) It is necessary for the proper performance of agency functions;
(b) It avoids unnecessary duplication;
(c) It reduces burden on small entities;
(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;
(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;
(f) It indicates the retention periods for recordkeeping requirements;
(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:
(i) Why the information is being collected;
(ii) Use of information;
(iii) Burden estimate;
(iv) Nature of response (voluntary, required for a benefit, or mandatory);
(v) Nature and extent of confidentiality; and
(vi) Need to display currently valid OMB control number;
(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.
(i) It uses effective and efficient statistical survey methodology (if applicable); and
(j) It makes appropriate use of information technology.
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
Certification Date:
09/18/2006
An official website of the United States government
The .gov means it's official.
The site is secure.
