Information Collection

Work Incentives Planning and Assistance Program (WIPA)--Project Sites and CWICs

IC 178887 under ICR 201604-0960-004 · 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⚠️ Notice: This information collection may be referencing outdated material.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)--Project Sites and CWICs Form
Work Incentives Planning and Assistance formerly BPAO WIPA Receipient Form.pdf Form
Work Incentives Planning and Assistance Community Work I Project Sites and CWICS Revised Versions.pdf Form
ETO System Fields ETO System Fields - Revised.pdf Form
WIPA Sites and CWICS Current Versions.docx WIPA Project Sites and CWICs Current Versions IC Document
ETO System Fields - Current.pdf ETO System Fields IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Work Incentives Planning and Assistance Program (WIPA)--Project Sites and CWICs	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	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	N/A	Work Incentives Planning and Assistance formerly BPAO	WIPA Receipient Form.pdf	Yes	Yes	Fillable Fileable Signable
Form	N/A	Work Incentives Planning and Assistance Community Work Incentives Coordinator (CWIC) Form	Project Sites and CWICS Revised Versions.pdf	Yes	Yes	Fillable Fileable
Form	N/A	ETO System Fields	ETO System Fields - Revised.pdf	Yes	Yes	Fillable Printable

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 30,000	Number of Respondents for Small Entity: 0

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

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	30,000	29,504	496
Annual IC Time Burden (Hours)	10,000	9,841	159
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded
WIPA Project Sites and CWICs Current Versions	WIPA Sites and CWICS Current Versions.docx	06/07/2013
ETO System Fields	ETO System Fields - Current.pdf	06/13/2016

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