Reminder Letter

OMB Control No. 0960-0526

Expiration Date: June 2012

MAXIMUS Ticket to Work

P.O. Box 1433

Alexandria, Virginia 22313

Insert Date

Dear (Insert Name),

About two weeks ago, we mailed you a survey asking how satisfied you are with your Employment Network, (Insert Name).

If you have already completed the survey on the internet or returned the survey by mail, thank you very much. If you have not completed the survey, please do so today. We need your help and value your opinion. Your responses will be private and they will help us improve services to you and others in the Ticket to Work program.

You may choose to complete the survey on the internet at a secure website, or by mail using the enclosed paper survey form and postage paid envelop. (You do not need to do both.) Many persons find it convenient to complete the online survey. If you choose to complete the online survey, below is the internet address and password.

Internet address: <insert web address>

Password: <insert unique identifier>.

If you have already told us that you do not want to participate or do not respond, you will not be contacted again.

If you have any questions about this survey, you may contact MAXIMUS at 866-968-7842. MAXIMUS is Social Security’s Operations Support Manager for the Ticket to Work program. Your response will be most helpful if received by December 12, 2010.

Sincerely,

MAXIMUS – Ticket to Work