PRA IC List
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Agenda
Reg Review
ICR
Information Collection List
IC Title
Status
Responses
Hours
Dollars
Document Type
Form No.
Form Name
20 CFR 411.140(d)(3); 411.150(b)(3); 411.325(a)
Modified
3983
15932
0
20 CFR 411.145 & 411.325
New
2532
633
0
20 CFR 411.170(b); 411.385(a); 411.390
New
35584
2965
0
20 CFR 411.192(b)&(c)
New
1000
500
0
20 CFR 411.200(b)--SSA-1375 (Beneficiaries)
New
13500
3375
0
Form
SSA-1375
Ticket to Work Progress Review Form
Instruction
Instruction
20 CFR 411.200(b)--SSA-1375 Internet Version (State ENs)
New
13500
1800
0
Form
SSA-1375
Ticket to Work Progress Review Form
Instruction
Instruction
Form
N/A
Electronic Data Exchange Response for Progress Reports (Draft Version)
20 CFR 411.210(b)
New
3145
1573
0
20 CFR 411.325(d), 411.415
New
48
384
0
20 CFR 411.325(f)
New
2470
4940
0
20 CFR 411.365, 411.505, 411.515
New
118
59
0
20 CFR 411.435, 411.615, 411.635
New
2
4
0
20 CFR 411.535(a)(1)(iii)
New
8505
709
0
20 CFR 411.575
New
12420
12420
0
411.140(d)(3); 411.385(a); 411.390 -- SSA-1365
New
25174
1259
0
Form
SSA-1365
State Agency Ticket Assignment Form Ticket to Work and Self-Sufficiency Program
Total burden requested under this ICR:
121981
46553
0
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