Information Collection

Ticket to Work (TTW) Outreach Effectiveness Survey

IC 212165 under ICR 201206-0960-002 · OMB 0960-0526.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0960-0526 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Survey Instrument with Correspondence.pdf	Other-survey
Survey Description - TTW Outreach Effectiveness Survey 2014.doc Survey Description - TTW Outreach Effectiveness Survey	IC Document

IC Title:

Ticket to Work (TTW) Outreach Effectiveness Survey

Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-survey			Survey Instrument with Correspondence.pdf		Yes	Yes	Fillable Fileable

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 7,000

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 35 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	7,000	7,000
Annual IC Time Burden (Hours)	1,167	1,167
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Survey Description - TTW Outreach Effectiveness Survey	Survey Description - TTW Outreach Effectiveness Survey 2014.doc	06/30/2014

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