How to Fill Out SSA Form 3288 (Consent for Release of Information)

As part of Public Law 104-193, the Human Responsibility and Work Opportunity Reconciliation Act of 1996 was enacted on August 22, 1996. SSI and food stamps are only available to certain excluded classes of qualified aliens under this new law. Lawfully admitted aliens to the United States for permanent residence under the Immigration and Nationality Act. They must have worked 40 qualifying quarters (QQ) or can be credited with 40 QQ to qualify for this exception. Aliens may be able to add the QQs of their parents or spouses to their records under certain conditions. After a Consent for Release of Information (SSA-3288) is completed and signed, the Social Security Administration (SSA) provides information on QQs via the Wire Third Party Query (WTPY) automated system.

When to Use This Form

It is necessary to obtain Consent for Release of Information forms (SSA-3288) after determining which Social Security numbers are required to request QQs histories. To request information regarding the applicant/recipient's 40 qualifying quarters of coverage, the parent(s) and spouse must complete and sign a Consent for Release of Information (SSA-3288).

You must submit this form if an individual or organization wants information or records about you from the Social Security Administration (for example, a doctor or insurance company). The consent form (SSA-3288) must only be completed and signed by the following individuals:

• In the case of information or records, it applies to the person who receives them.
• If the nonmedical information pertains to a minor, the parent or legal guardian should be notified
• A legally incompetent adult whose legal guardian is responsible for providing the information.

Note: The SSA-3288 is not to be used for requesting earnings information or employment history.

How To Fill Out A Form 3288

The following are the steps you can follow to fill out an SSA Form 3288.

Step 1 – Download The PDF Document

• To ensure that the agency The capacity of individuals with disabilities to act independently and make their own choices. will have what is needed to expedite the applicant's needs properly, the applicant must carefully review all of the information provided on the first page.
• Social Security Offices can be contacted directly, or the applicants can visit their local offices for more comprehensive assistance if the document is too difficult to understand.

Step 2 – Submit The Following Information

• The full name of the applicant
• The date of birth should be formatted as mm/dd/yyyy
• The applicant's Social Security Number

Step 3 – Authorize The Release Of The Applicant's Records By Providing:

• Names of individuals or organizations
• Use the line provided to enter the reason for the release of the information

Step 4 – Choose From The Following List Of The Information That Must Be Released

• The applicant's Social Security Number
• The current amount of Social Security benefits
• The current amount of the monthly SSI payment
• An estimated monthly benefit amount from mm/dd/yyyy to mm/dd/yyyy
• Medicare A U.S. federal health insurance program for people aged 65 and older, and for some younger people wi. entitlement from mm/dd/yyyy to mm/dd/yyyy format
• Documents from claims folders in mm/dd/yyyy format (contact your local social security office for proper forms for minor children)
• A complete set of medical records from the claim folder(s)
• The other records from the files should be specified on the lines provided

Step 5 – Signatures

Applicants must carefully read and agree to all sections of the application form before signing and then provide the following information:

• An applicant's signature as themselves or as caregivers
• Signature date formatted as mm/dd/yyyy
• Address in its entirety
• Relationship to applicant (if not already documented)
• Contact information for daytime

An applicant's signature must be an "X" or some other dedicated mark for a witness to sign:

• The signatures of the witnesses
• A complete address for each witness, including the zip code

Want to know if you're under investigation by the SSA and what it means? Check out one of our articles to learn more.

Applying for Social Security's cash benefits can be an overwhelming process. If you are interested in seeking SSDI benefits, check out our article about what you can do for income while you waiting for disability. To learn more, please visit DisabilityHelp.org today!