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View Information Collection (IC)

Retaining Employment and Talent after Injury/Illness Network (RETAIN) Demonstration Projects and Evaluation 201803-0320-001
 
No Modified
 
Required to Obtain or Retain Benefits
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-Survey Yes Yes Fillable Fileable
Other-Survey Yes Yes Fillable Fileable
Form and Instruction RETAIN SSA Authorization of Disclosure Form Yes Yes Fillable Printable
Form and Instruction Spanish version of Disclosure Form Yes Yes Fillable Printable
Other-Survey Yes Yes Fillable Fileable
Other-Survey Yes Yes Fillable Fileable
Other-Survey Yes Yes Fillable Fileable
Other-Survey Yes Yes Fillable Fileable
Other-Survey Yes Yes Fillable Fileable

Workforce Management Training and Employment

 

5,333 0
   
Individuals or Households
 
   0 %

  Approved 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 5,333 0 0 0 0 5,333
Annual IC Time Burden (Hours) 1,778 0 0 0 0 1,778
Annual IC Cost Burden (Dollars) 146,817 0 0 0 0 146,817

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