Work Incentives Planning and Assistance Program (WIPA)- (Small Site Under 150 Beneficiaries served)

Work Incentives Planning and Assistance (WIPA)

OMB: 0960-0629

IC ID: 9650

Information Collection (IC) Details

View Information Collection (IC)

Work Incentives Planning and Assistance Program (WIPA)- (Small Site Under 150 Beneficiaries served)
 
No Removed
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form SSA-4565 WIPA Beneficiary/Recipient Application SSA 4565 Mockup.pdf Yes Yes Fillable Fileable
Form SSA-4566 WIPA CASE NOTES SSA 4566 Mock-up.pdf No   Paper Only

Income Security General Retirement and Disability

 

4,800 0
   
Individuals or Households
 
   100 %

  Requested Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 0 0 -4,800 0 0 4,800
Annual IC Time Burden (Hours) 0 0 -1,600 0 0 1,600
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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

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