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

Work Incentives Planning and Assistance (WIPA)

⚠️ Notice: This information collection may be referencing outdated material.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 Receipient Form.pdf Form
Work Incentives Planning and Assistance Community Work I Screen Shots.docx Form

Information Collection (IC) Details

IC Title:	Work Incentives Planning and Assistance Program (WIPA)--Businesses	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	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	Screen Shots.docx		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: 496	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	Previously Approved
Annual Number of Responses for this IC	496	-73	569
Annual IC Time Burden (Hours)	159	140	19
Annual IC Cost Burden (Dollars)	0	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.