Information Collection

Work Incentives Planning and Assistance Program (WIPA)--Businesses

IC 178887 under ICR 200701-0960-012 · OMB 0960-0629.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0960-0629 can be found here:

Documents and Forms

Document Name Document Type
Work Incentives Planning and Assistance Program (WIPA)--Businesses Form
Work Incentives Planning and Assistance formerly BPAO WIPA - Site Form.doc Form
Work Incentives Planning and Assistance Community Work I WIPA - CWIC Form.doc Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Work Incentives Planning and Assistance Program (WIPA)--Businesses	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	N/A	Work Incentives Planning and Assistance formerly BPAO	WIPA - Site Form.doc		Yes	Yes	Fillable Fileable Signable
Form	N/A	Work Incentives Planning and Assistance Community Work Incentives Coordinator (CWIC) Form	WIPA - CWIC Form.doc		Yes	Yes	Fillable Fileable Signable

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 569	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Change Due to Adjustment in Agency Estimate
Annual Number of Responses for this IC	569	569
Annual IC Time Burden (Hours)	19	19
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

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