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SSA-545
Plan For Achieving Self-Support
Download and Print
the SSA-545
Request may not be processed if the form is incomplete or illegible.
A plan for achieving self--support, or PASS for short, is a plan for your future. Many people with disabilities want to work, and you're probably one of them. But maybe you need to go back to school before you can get a job. Or, maybe you'd like to start your own business, but you don't have the money. Whatever your work goal may be, a PASS can help you reach it.
_____________________________
In
order
to
minimize
recontacts
or
processing
delays,
please
complete
all
questions
and
provide
thorough
explanations
where
requested.
If
you
need
additional
space
to
answer
any
questions,
use
the Remarks
section
or
a
separate
sheet
of
paper.
Name
SSN
PART I YOUR
WORK GOAL
A
.
What
is
your
work
goal?
(
Show
the
job
you
expect
to
have
at
the
end
of
the
plan.
Be
as
specific
as
possible.
If
you
cannot
be
specific,
provide
as
much
information
as
possible
on
the
type
of
work
you
plan
to
do.
If
you
do
not
yet
have
a
specific
goal
and
will
be
working
with
a
vocational
professional
to
find
a
suitable
job
match,
show "VR
Evaluation"
and
be
sure
to
complete
Part
II,
question
F
on
page
4.
)
If
your
plan
involves
paying
for
job
coaching,
show
the
number
of
hours
of
job
coaching
you
will
receive when
you
begin
working.
per
week
month
(check
one)
.
Show
the
number
of
hours
of
job
coaching
you
expect
to
receive
after
the
plan
is
completed.
per
week
month
(check
one)
.
B.
Describe
the
duties
and
tasks
you
expect
to
perform
in
this
job.
Be
as
specific
as
possible.
C.
How
did
you
decide
on
this
work
goal
and
what
makes
this
type
of
work
attractive
to
you?
And much more... |
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