View Information Collection Request (ICR) Package

OMB Control No: 0960-0848	ICR Reference No: 202607-0960-010
Status: Active	Previous ICR Reference No:
Agency/Subagency: SSA	Agency Tracking No:
Title: Request for Individual Access to Records Protected Under the Privacy Act
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR: No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 09/09/2026
	Date Received in OIRA: 07/31/2026
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	09/30/2029	36 Months From Approved
Responses	1,097	0	0
Time Burden (Hours)	768	0	0
Cost Burden (Dollars)	0	0	0

Abstract: The Creating Advanced Streamlined Electronic Services for Constituents Act of 2019 (CASES Act), Pub. L. 116-50, 133 Stat. 1073 (2019), requires Federal agencies to establish a digital process for identity-proofed and authenticated individuals to request access to their records protected by the Privacy Act of 1974 (Privacy Act) (5 U.S.C. 552a of the United States Code). To comply with the CASES Act and OMB Memorandum, M 21-04, and pursuant to authority under sections 702(a)(5) and 1106(a) of the Social Security Act (42 U.S.C. 902(a)(5), 1306(a)), the Social Security Administration (SSA) developed Form SSA-2288-OP1, Request for Individual Access to Records Protected Under the Privacy Act, a dynamic webform that guides respondents through the information necessary to submit an electronic request for access to agency records about themselves. Under SSA’s regulations at 20 CFR 401.40 regarding individuals’ access rights under the Privacy Act (5 U.S.C. 552a(f)), individuals may request access to their records by visiting their local Social Security field office or writing to the manager of the applicable system of records. Since SSA currently has no special agency form available to the public to submit this type of request, we are implementing Form SSA-2288-OP1 to comply with the CASES Act, the Privacy Act, OMB M 21-04, and SSA’s governing regulations at 20 CFR 401.30 - 401.95. Form SSA-2288-OP1 is an electronic webform that respondents submit online only via SSA’s Upload Documents portal (OMB No. 0960-0830), after the portal first appropriately identity-proofs and authenticates respondents, consistent with requirements in the CASES Act and OMB M 21-04. Respondents can use Form SSA-2288-OP1 to request access to records or information about themselves from SSA’s program files. Pursuant to the Privacy Act and SSA’s regulations, a special procedure governs access requests that include medical records (5 U.S.C. 552a(f)(3) and 20 CFR 401.55). Therefore, respondents requesting medical record requests via Form SSA-2288-OP1 must designate an individual (such as a health professional or other responsible individual) to receive and review the records and inform the respondent of its contents. SSA may grant the respondent direct access to their medical records if it determines direct access is not likely to have an adverse effect on the respondent. Respondents who cannot (or do not wish to) submit their request electronically or seek other types of records can always avail themselves of SSA’s existing service delivery channels, such as visiting or calling their local Social Security office, or submitting a written request by mail, fax, or hand delivery. Respondents can learn more about SSA’s privacy program from its privacy webpage at www.ssa.gov/privacy, which contains sub-pages with additional information about Privacy Act requests and a link to Form SSA-2288-OP1. Respondents may also find Form SSA-2288-OP1 within the Upload Documents portal, or on SSA’s Forms webpage at www.ssa.gov/forms. Respondents are the subjects of the record(s) protected by the Privacy Act, who request access to agency records about themselves.

Authorizing Statute(s): None

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:
	91 FR 30774	05/26/2026
30-day Notice:	Federal Register Citation:	Citation Date:
	91 FR 48475	07/31/2026
Did the Agency receive public comments on this ICR? No

Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
SSA-2288-OP1 - Request for Individual Access to Records Protected Under the Privacy Act	SSA-2288-OP1

ICR Summary of Burden

	Total Approved	Change Due to Agency Discretion
Annual Number of Responses	1,097	1,097
Annual Time Burden (Hours)	768	768
Annual Cost Burden (Dollars)	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: This is a new form that increases the public reporting burden. See the chart above and #12 of the Supporting Statement for burden figures. *Note: The total burden reflected in ROCIS is 768, while the burden cited in #12 of the Supporting Statement is 219. This discrepancy is because the ROCIS burden also reflects the learning costs. In contrast, the chart in #12 above reflects actual burden.

Annual Cost to Federal Government: $720,617

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination. Yes

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination. Yes

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? No

Agency Contact: Faye Lipsky 410 965-8783 faye.lipsky@ssa.gov

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