Updated EN Split Payment Request Form
Ticket to Work sent this bulletin at 05/20/2025 01:10 PM EDTUpdated EN Split Payment Request Form
The Social Security Administration (SSA) would like to inform all Employment Networks (EN) that an updated EN Split Payment Request Form is now posted to the Forms section on the Your Ticket to Work website.
Effective immediately, SSA will no longer accept previous versions of this form. ENs must use the updated form when submitting requests for split payments.
If you have any questions about the updated form, please contact the Provider Help Desk at 1-866-949-3687, option 2.
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Approved service providers for Social Security’s Ticket to Work Program offer career development services for people ages 18 through 64 who receive Social Security disability benefits (SSI or SSDI) and want to work. |
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