PLAN FOR ACHIEVING SELF SUPPORT
December 1, 1994

Name: Donna

SSN:

1. My work goal is: Small Business Manager

2. I want my plan to begin: December 1, 1994
I expect to reach my goal by: December 1, 1998

Note: I believe that it will take 4 years for me to become a Small Business Manager, this PASS is only outlining the first 18 month period of that goal (and only requesting approval for the first 18 months).

3. I will have the following expenses, during the first 18 months, in order to reach my goal:

ITEM RELATION TO GOAL, MONTHS PAID, COST PER MONTH, TOTAL
Voice Recognition Computer, Software, & Peripherals, including taxes and finance charges. Required for goal achievement: Note: Initial software & training included in computer purchase. 12/94--6/96, $450.00/mo. $8100.00/total.

Maintenance of computer equipment and software. 1st year warrantee and repair extensions &/or maintenance. 12/94-6/96, $60.00/mo. $1080.00/total.

On-Line information services. Required for goal achievement. 12/94-6/96, $25.00/mo. $450.00/total.

TOTAL 18 months, $535.00 $9,630.00

NOTE: The above expenses are shown evenly amortized over the first 18 months. I anticipate that the actual monthly expenses will not reflect the "even amortization" shown above but will vary based on the billing cycles and amounts associated with the specific expense. The final totals for each item are believed to be accurate estimates at this point.

4. I already have the following money or property that I will use to reach this goal:

None

5. I expect to receive the following income that I will use to reach the goal:

$553.00 SSDI per month

6. I will keep the money I set aside under my plan in the following bank account: A separate checking account will be set up upon approval of this PASS.

7. I am already working toward this goal.

8. Signature__________________________Date________

9. Individuals who helped me with this plan:

David G. Hammis
Project Coordinator, & Social Security Training Specialist
University of Northern Colorado
CTAT, Center for Technical Assistance & Training
Greeley, Co 80639
303-351-6895
1-800-682-1240