View Information Collection (IC)

View Information Collection (IC)

View Information Collection (IC)

IC Title:	Work Incentive Planning and Assistance (WIPA) Customer Comment Instrument	Agency IC Tracking Number:

IC Status: Unchanged

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
Other-WIPA Sample					No		Paper Only

Federal Enterprise Architecture Business Reference Module

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 20,400	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Requested	Program Change Due to New Statute	Program Change Due to Agency Discretion	Change Due to Adjustment in Agency Estimate	Change Due to Potential Violation of the PRA	Previously Approved
Annual Number of Responses for this IC	20,400	0	0	0	0	20,400
Annual IC Time Burden (Hours)	2,380	0	0	0	0	2,380
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
Description WIPA Customer Comment Instrument		11/21/2017

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

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