CPA Compliance Review and Report

Electronic Consent Based Social Security Number Verification

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0960-0817 can be found here:

Documents and Forms

Document Name Document Type
Form eCBSV User Agreeme CPA Compliance Review and Report Form and Instruction
eCBSV FRN Webpage Language (02-01-2021).docx www.ssa.gov Other-eCBSV Webpage Content
eCBSV FRN Webpage Language (02-01-2021).docx www.ssa.gov Other-eCBSV Webpage Content
eCBSV Screen Package.docx www.ssa.gov Other-Internet Screens
eCBSV Screen Package.docx www.ssa.gov Other-Internet Screens
eCBSV User Agreeme eCBSV User Agreement eCBSV User Agreement - Revised.docx www.ssa.gov Form and Instruction
eCBSV User Agreeme eCBSV User Agreement eCBSV User Agreement (6-7-21) - Clean Copy.docx www.ssa.gov Form and Instruction
eCBSV User Agreement - Current.pdf Current User Agreement IC Document
eCBSV User Agreement - Current.pdf Current User Agreement IC Document
eCBSV User Agreement (6-7-21) - Track Changes.docx eCBSV Revised User Agreement - Track Changes IC Document

Information Collection (IC) Details

IC Title:	CPA Compliance Review and Report	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 20 CFR 401.100

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	eCBSV User Agreement	eCBSV User Agreement	eCBSV User Agreement (6-7-21) - Clean Copy.docx	www.ssa.gov	Yes	Yes	Fillable Fileable Signable
Other-eCBSV Webpage Content			eCBSV FRN Webpage Language (02-01-2021).docx	www.ssa.gov	Yes	Yes	Fillable Fileable Signable
Other-Internet Screens			eCBSV Screen Package.docx	www.ssa.gov	Yes	Yes	Fillable Fileable Signable

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 113	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	113	103	10
Annual IC Time Burden (Hours)	9,040	8,240	800
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded
Current User Agreement	eCBSV User Agreement - Current.pdf	03/26/2021
eCBSV Revised User Agreement - Track Changes	eCBSV User Agreement (6-7-21) - Track Changes.docx	06/08/2021

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.