Form SSA-3288 Consent for Release of Information

Form SSA-3288 Consent for Release of Information

What Is Form SSA-3288?

Form SSA-3288, Consent for Release of Information , is a form used for providing the U.S. Social Security Administration (SSA) with written permission to release your personal information maintained by the SSA to a third-party individual or group, like doctors or an insurance company.

Alternate Names:

  • SSA Form 3288;
  • SSA Consent for Release of Information Form.

The latest version of the form was issued on February 1, 2023 , with all previous editions obsolete. An SSA 3288 fillable form is available for download and digital filling below. Form SSA-3288-SP is available for Spanish-speaking individuals.

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What Is Form SSA-3288 Used For? {id="mcetoc_1fh8bp05k0"}

Fill out the SSA Information Release Form when you need to provide a third-party individual or group with your Social Security record or some specific information from this record. Do not complete this form to request information about your employment history or earnings. Submit the SSA-7050-F4 instead.

This form can be used to release information about a minor or legally incompetent adult. However, if you are a legal guardian or parent of a minor child, you can use this form to request a release of non-medical information only. To release medical records of a minor child, visit your local SSA office, or call the toll-free number provided on the first page of the form.

SSA Form 3288 Instructions {id="mcetoc_1fh8bp05k1"}

Form SSA-3288 instructions are provided on the first page of the document. Besides, you can find step-by-step filling out instructions below. For your request to be processed by the SSA, complete all required fields. The required fields are marked with an asterisk (*).

  1. Provide your name, date of birth, and Social Security Number (SSN). If you request the release of information on behalf of a minor or incompetent person, specify the details of this person.
  2. Indicate the name and the address of the person or company the information should be released to.
  3. Provide the reason why you want the SSA to release your information. The SSA may charge a fee for the release of information for non-program purposes.
  4. Check the appropriate boxes to specify the type of information you want the SSA to release. Include the date ranges if applicable.
  5. Sign and date the form. Provide your address and daytime phone number in case the SSA needs to contact you regarding this form.
  6. If you are not the individual indicated at the top part of the form, specify your relationship to that individual. The SSA may require you to provide some proof of that relationship.
  7. If you sign with the mark "X," ask two witnesses who know you to sign the form and to provide their full addresses.

Where to Send Form SSA-3288? {id="mcetoc_1fh8bp05k2"}

Send or bring the release of information to the nearest Social Security office. Check up the address of your local office on the SSA official website. You can also find it in your telephone directory under U.S. Government agencies or by calling the toll-free number provided on the first page of the form.


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