Who is eligible for pass?

Who is eligible for a PASS? If you receive SSI or can become eligible for SSI, a PASS allows you to set aside income or resources to use for your career goals.

What is the purpose of a plan to achieve self-support?

The Plan to Achieve Self- Support, or PASS, is a Social Security work incentive that allows a person with a disability to set aside income and/or resources to reach an employment goal within a specified period of time.

What is an example of a pass plan?

A PASS is a plan for your future that allows you to use your income or other things you own to help you reach your work goals. For example, you could set aside money to go to school to get specialized training for a job or to start a business.

What is Form SSA 821?

Social Security uses the Work Activity Report form to learn more about the work activity of a disability applicant or beneficiary. If you are applying for disability benefits, the information you provide will help us decide if you can receive benefits.

Get Pass Form

AM Route Valid INSTRUCTIONS TO REQUEST FOR DUPLICATE BUS PASS FORM ST-73 1. Print legibly your child s name address phone school teacher s name and room number. STATE OF HAWAI I DEPARTMENT OF EDUCATION REQUEST FOR DUPLICATE BUS PASS FORM ST-73 This form must be completed by Parent or Guardian Name of Student Street Address no P. O. Box Address City/Town Phone School Teacher s name/Room number TYPE OF PAYMENT PLAN Annual Quarterly Signature of Parent or Guardian Date FOR SCHOOL USE ONLY Bus Co. 2. Indicate the payment plan you are currently enrolled in* 3. Sign and date the form* 4. Return the completed form with a check money order cashier s check or cash for 5. 00 payable to the Department of Education to the school office. 5. The school will issue a temporary bus pass provided that the student s account is in good standing. 6. Your child s new bus pass will be sent to his/her school* Rev* 7/07 RS 08-0038 Rev* of RS 05-1101. STATE OF HAWAI I DEPARTMENT OF EDUCATION REQUEST FOR DUPLICATE BUS PASS FORM ST-73 This form must be completed by Parent or Guardian Name of Student Street Address no P. O. Box Address City/Town Phone School Teacher s name/Room number TYPE OF PAYMENT PLAN Annual Quarterly Signature of Parent or Guardian Date FOR SCHOOL USE ONLY Bus Co. 2. Indicate the payment plan you are currently enrolled in* 3. Sign and date the form* 4. Return the completed form with a check money order cashier s check or cash for 5. 00 payable to the Department of Education to the school office. 5. The school will issue a temporary bus pass provided that the student s account is in good standing. 00 payable to the Department of Education to the school office. 5. The school will issue a temporary bus pass provided that the student s account is in good standing. 6. Your child s new bus pass will be sent to his/her school* Rev* 7/07 RS 08-0038 Rev* of RS 05-1101. 2. Indicate the payment plan you are currently enrolled in* 3. Sign and date the form* 4. Return the completed form with a check money order cashier s check or cash for 5. 00 payable to the Department of Education to the school office. 5. The school will issue a temporary bus pass provided that the student s account is in good standing. 6. Your child s new bus pass will be sent to his/her school* Rev* 7/07 RS 08-0038 Rev* of RS 05-1101.

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