WIPA STAR System

Work Incentives Planning and Assistance (WIPA)

Documents and Forms

Document Name Document Type
WIPA STAR Screens.pdf Other-WIPA Star Screens
Attachment H WIPA STAR system fields .docx Other-WIPA Star System Fields
Attachment I_Master list of elements .docx Other-Master list of WIPA Star Scree

Information Collection (IC) Details

IC Title:	WIPA STAR System	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-WIPA Star Screens	WIPA STAR Screens.pdf	Yes	Yes	Fillable Fileable
Other-WIPA Star System Fields	Attachment H WIPA STAR system fields .docx	No		Paper Only
Other-Master list of WIPA Star Screen Elements	Attachment I_Master list of elements .docx	No		Paper Only

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 720	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Requested	Change Due to Adjustment in Agency Estimate
Annual Number of Responses for this IC	1,345,680	1,345,680
Annual IC Time Burden (Hours)	448,560	448,560
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.