Form SSA-4566 WIPA Case Notes

Work Incentives Planning and Assistance (WIPA)

SSA 4566 Mock-up

Work Incentives Planning and Assistance Program (WIPA) - Large Site (600 or more beneficiaries served)

OMB: 0960-0629

⚠️ Notice: This form may be outdated. More recent filings and information on OMB 0960-0629 can be found here:

2022-06-02 - Revision of a currently approved collection

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File Modified	2019-02-04
File Created	2019-02-04

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