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Form SSA-1391 Employment Network Payment Request Form
The Ticket to Work and Self-Sufficiency Program
SSA-1391
f) 20 CFR 411.575 - Requesting EN Payments - SSA-1391; SSA-1398
OMB: 0960-0644
OMB.report
SSA
OMB 0960-0644
ICR 202401-0960-002
IC 184462
Form SSA-1391 Employment Network Payment Request Form
( )
⚠️ Notice: This form may be outdated. More recent filings and information on OMB 0960-0644 can be found here:
2024-04-08 - No material or nonsubstantive change to a currently approved collection
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