c) 20 CFR 411.200(b) - SSA-1375

The Ticket to Work and Self-Sufficiency Program

OMB: 0960-0644

IC ID: 184457

Information Collection (IC) Details

View Information Collection (IC)

c) 20 CFR 411.200(b) - SSA-1375
 
No Unchanged
 
Required to Obtain or Retain Benefits
 
20 CFR 411.200(b)

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form SSA-1375 Ticket to Work Progress Review Form SSA-1375 (revised).pdf No   Paper Only

Income Security General Retirement and Disability

 

179 0
   
Individuals or Households
 
   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 179 0 0 0 0 179
Annual IC Time Burden (Hours) 90 0 0 0 0 90
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
SSA-1375 (current) SSA-1375 (current).pdf 12/07/2023
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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