Information Collection

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

IC 9650 under ICR 201305-0960-013 · 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⚠️ Notice: This information collection may be referencing outdated material.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)--Beneficiaries Form
WIPA Beneficiary/Recipient Application WIPA Recipient Forms Revised Versions.pdf Form
WIPA_Receipient_Forms Current Version.pdf WIPA Recipients Current Versions IC Document

Information Collection (IC) Details

View Information Collection (IC)

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

Is this a Common Form? No		IC Status: Modified

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	WIPA Beneficiary/Recipient Application	WIPA Recipient Forms Revised Versions.pdf		Yes	Yes	Fillable Fileable

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 40,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Previously Approved
Annual Number of Responses for this IC	40,000	40,000
Annual IC Time Burden (Hours)	20,000	20,000
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
WIPA Recipients Current Versions	WIPA_Receipient_Forms Current Version.pdf	06/07/2013

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