SSA-3288 2016 free printable template

Send only comments relating to our time estimate to this address not the completed form. Form SSA-3288 07-2013 EF 07-2013 Destroy Prior Editions You must complete all required fields.

How to fill out SSA-3288

How to fill out SSA-3288

1. Obtain a copy of the SSA-3288 form from the Social Security Administration's website or local office.
2. Fill in your full name at the top of the form.
3. Provide your Social Security number to identify your records.
4. Enter your date of birth for verification purposes.
5. Specify the type of request (e.g., for employment or education purposes).
6. Indicate whom you are authorizing to access your information (e.g., employer, school).
7. Provide the contact information for the party requesting your records.
8. Sign and date the form at the bottom to give consent.
9. Submit the completed form to the Social Security Administration or the designated party.

Who needs SSA-3288?

1. Individuals who want to authorize disclosure of their Social Security records.
2. Job applicants required to provide employment history to potential employers.
3. Students applying for educational programs that require verification of benefits.
4. People who need to confirm their Social Security earnings for mortgage or loan applications.

• Who needs the SSA-3288 form?
• What is the purpose of the SSA-3288 form?
• What documents must accompany the SSA-3288 form?
• How long does it take to fill out the SSA-3288 form?
• • What information should be provided in the SSA-3288 form?
  • What do I do with the SSA-3288 form after its completion?

Who needs the SSA-3288 form?

The form is used if the individual wants to give his/her personal information to a person or group of people (for example, to a doctor or insurance company). The document is signed by the individual and forwarded to the Social Security Administration.

What is the purpose of the SSA-3288 form?

The information in the Consent for Release is used by the Social Security Administration to give the individual’s records to the third party. The form can be completed by the legal guardian on behalf of the minor or the legal guardian of the legally incompetent adult.

What documents must accompany the SSA-3288 form?

As a rule, there is no need to attach other documents to this form.

How long does it take to fill out the SSA-3288 form?

The estimated time for completing the form is 10 minutes.

What information should be provided in the SSA-3288 form?

The applicant must type the following information:

• Name, date of birth, Social security number of the applicant
• Name, address of the person who is authorized to receive the personal information about the applicant from the Social Security Administration.
• Reason for releasing the information
• Type of the information to be released (check the appropriate box): Social Security Number; current monthly Supplemental Security income payment amount; benefit/payment amounts; medicare entitlement; medical records; others records).

The applicant should also sign and date the consent form, indicate his/her phone number and relationship to the individual (in case he/she acts as a legal representative).

Keep in mind that Social Security Administration will not honor the form unless all the required fields are completed.

What do I do with the SSA-3288 form after its completion?

The completed and signed Consent for release of information is forwarded to the local Social Security Office.

People Also Ask about

Where do I send SSA consent for release of information?

The office is listed under U. S. Government agencies in your telephone directory or you may call 1-800-772-1213 for the address. You may send comments on our estimate of the time needed to complete the form to: SSA, 1338 Annex Building, Baltimore, MD 21235-6401.

What are SSA documents?

Documents we may ask for include: Your Social Security card or a record of your number. Your original birth certificate, a copy certified by the issuing agency, or other proof of your age. We must see the original document(s), or copies certified by the agency that issued them.

What is SSA 89 form used for?

What Is Form SSA-89? Form SSA-89 is a Social Security form that authorizes the SSA to verify the connection between your name and your Social Security Number to a third party.

What is the purpose of a SSA?

To protect aged and disabled persons against the expenses of illnesses that may otherwise use up their savings; To keep families together; and. To give children the chance to grow up healthy and secure.

What is a SSA 795 form used for?

Individuals use Form SSA-795 to make signed statements relating to claims for Social Security benefits or Supplemental Security Income (SSI) payments under 20 CFR 404.702 and 416.570 of the Code of Federal Regulations.

What is SSA form of consent?

A Social Security Administration Consent for Release of Information, also known as “Form SSA-3288”, is a document that is used to provide official, written permission for a group such as a doctor, insurance company or any other group who may require specific information for a person, caregiver for an incompetent adult,

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What is SSA-3288?

SSA-3288 is a form used by the Social Security Administration (SSA) to authorize the release of an individual's Social Security records to designated third parties.

Who is required to file SSA-3288?

Individuals who want to allow the SSA to disclose their personal information, such as medical records or earnings, to another party must file SSA-3288.

How to fill out SSA-3288?

To fill out SSA-3288, an individual must provide their personal information, specify the information to be disclosed, identify the third party that will receive the information, and sign and date the form.

What is the purpose of SSA-3288?

The purpose of SSA-3288 is to authorize the Social Security Administration to share an individual's personal records with a specified third party for purposes such as legal, medical, or social services.

What information must be reported on SSA-3288?

The information reported on SSA-3288 includes the individual's name, Social Security number, the information to be released, the name and address of the person or agency receiving the information, and the individual's signature.