a) 20 CFR 411.140(d)(2) - Ticket Assignability - Portal

The Ticket to Work and Self-Sufficiency Program

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0960-0644 can be found here:

Documents and Forms

Document Name Document Type
Secure Provider Portal Screens.pdf Other-Internet Screens
Secure Provider Portal Screens.pdf Other-Internet Screens
Portal Phase II Forms.pdf Other-Internet Screens
Portal Phase II Forms.pdf Other-Internet Screens
DemoDeck.pptx Other-screens
DemoDeck.pptx Other-screens

Information Collection (IC) Details

IC Title:	a) 20 CFR 411.140(d)(2) - Ticket Assignability - Portal	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Unchanged

Obligation to Respond: Voluntary

CFR Citation: 20 CFR 411.140(d)(2)

Information Collection Instruments:

Document Type	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Internet Screens	Secure Provider Portal Screens.pdf	Yes	Yes	Fillable Fileable Signable
Other-Internet Screens	Portal Phase II Forms.pdf	Yes	Yes	Fillable Fileable Signable
Other-screens	DemoDeck.pptx	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: 25,713	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Previously Approved
Annual Number of Responses for this IC	25,713	25,713
Annual IC Time Burden (Hours)	536	536
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

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