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i) 20 CFR 411.320 - SSA-1394, EN Contract Changes
The Ticket to Work and Self-Sufficiency Program
OMB: 0960-0644
IC ID: 190204
OMB.report
SSA
OMB 0960-0644
ICR 201809-0960-003
IC 190204
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0960-0644 can be found here:
2024-04-08 - No material or nonsubstantive change to a currently approved collection
2024-01-18 - No material or nonsubstantive change to a currently approved collection
Documents and Forms
Document Name
Document Type
Form SSA-1394
i) 20 CFR 411.320 - SSA-1394, EN Contract Changes
Form and Instruction
SSA-1394 Employment Network Contract Change Form
SSA-1394 - Revised Version.pdf
Form and Instruction
SSA-1394 - Current Version.pdf
Current SSA-1394
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
i) 20 CFR 411.320 - SSA-1394, EN Contract Changes
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Unchanged
Obligation to Respond:
Mandatory
CFR Citation:
20 CFR 411.320
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form and Instruction
SSA-1394
Employment Network Contract Change Form
SSA-1394 - Revised Version.pdf
Yes
No
Paper Only
Federal Enterprise Architecture Business Reference Module
Line of Business:
Income Security
Subfunction:
General Retirement and Disability
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
52
Number of Respondents for Small Entity:
0
Affected Public:
Private Sector
Private Sector:
Businesses or other for-profits
Percentage of Respondents Reporting Electronically:
0 %
Approved
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
52
0
0
0
0
52
Annual IC Time Burden (Hours)
9
0
0
0
0
9
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Current SSA-1394
SSA-1394 - Current Version.pdf
04/17/2012
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.