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OMB Control No: 0960-0644	ICR Reference No: 201506-0960-011
Status: Historical Active	Previous ICR Reference No: 201408-0960-012
Agency/Subagency: SSA	Agency Tracking No:
Title: The Ticket to Work and Self-Sufficiency Program, 20 CFR 411
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR: No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 08/14/2015
	Date Received in OIRA: 06/24/2015
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	11/30/2015	11/30/2015	11/30/2015
Responses	369,914	0	360,414
Time Burden (Hours)	57,416	0	55,833
Cost Burden (Dollars)	0	0	0

Abstract: SSA is requesting to incorporate a new modality of the collection instrument Form SSA-1370, an electronic, web-based version of the individual work plan to assist Ticket to Work program participants to take advantage of increased employment opportunities via virtual job fairs. Through its Ticket to Work Program Manager, SSA uses the information collected to operate and manage the Ticket to Work Program. SSA uses the Ticket to Work Program to assign Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) beneficiaries to a service provider, and follows their progress through the various stages of ticket program participation such as progress reviews or changes in ticket status. Most of the collections in this request require service providers to provide information to SSA for such tasks as selecting a payment system or requesting payments for helping the beneficiary achieve certain work goals. Most of the categories of information collected in this request are required for SSA to be in compliance with the Ticket to Work legislation and provide proper oversight of the program. The respondents are SSDI beneficiaries and blind or disabled SSI beneficiaries and their employment networks or State vocational rehabilitation agencies under the Ticket to Work Program.

Authorizing Statute(s): US Code: 42 USC 405 Name of Law: Social Security Act
US Code: 42 USC 1320b¿19 Name of Law: Social Security Act

Citations for New Statutory Requirements: None

Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	77 FR 47908	08/10/2012
30-day Notice:	Federal Register Citation:	Citation Date:
	77 FR 65044	10/24/2012
Did the Agency receive public comments on this ICR? No

ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to Adjustment in Estimate
Annual Number of Responses	369,914	360,414	9,500
Annual Time Burden (Hours)	57,416	55,833	1,583
Annual Cost Burden (Dollars)	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement:

Annual Cost to Federal Government: $7,000,000

Does this IC contain surveys, censuses, or employ statistical methods? No

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

Agency Contact: Faye Lipsky 410 965-8783 faye.lipsky@ssa.gov

View ICR - OIRA Conclusion