Get Ssa 1374 2017-2025

Filling out the SSA 1374 form, also known as the Ticket Program Agreement Change Form, is essential for those involved in the Employment Network. This guide provides clear, step-by-step instructions to help users navigate the online process efficiently.

Follow the steps to fill out the SSA 1374 online:

1. Press the ‘Get Form’ button to obtain the SSA 1374 form. This will allow you to view and fill out the document in your preferred online format.
2. In Section One, provide the required general information. Enter the Employment Network (EN) name, DUNS number, the name of the person submitting the form, their title, and the date of request. Ensure that all required fields marked with an asterisk (*) are completed accurately.
3. Update any changes for your Employment Network. For instance, if your Doing Business As (DBA) name has changed or if there are any updates to your mailing or physical address, ensure these are indicated in the appropriate fields.
4. Move to Section Two to provide additional EN information. Answer questions about the method of providing services (in-person, virtually, or both) and indicate any specialization in areas such as youth-in-transition or veterans. Also, specify the type of organization and services offered.
5. In Section Three, update contact information for the signatory authority, program contact, suitability contact, payments contact, and ticketholder contact. Include names, phone numbers, and emails, ensuring the information is current.
6. Continue to Section Four if there are multiple site locations. Specify if you want to add, update, or remove a site and fill in the relevant details, including physical addresses and contact names.
7. Finally, review all the information provided in Section Five. Ensure accuracy and completeness, adding any additional relevant information or clarifications as necessary. The form must be signed by the signatory authority or program contact.
8. Once completed, submit the form to the Employment Network Service Team via their designated email address or fax number. You may choose to save changes, download or print the form for your records before submission.

Don't delay; complete and submit your SSA 1374 online today to ensure your Employment Network stays up to date.