Ticket Program Agreement (TPA) Termination FormProgram Agreement • January 15th, 2018
Contract Type FiledJanuary 15th, 2018Use this form to request termination of your TPA and unassign all assigned Tickets. This form should be submitted by the Signatory Authority directly to the Employment Network Service Team (ENST). ENST can be reached by email at ENService@ssa.gov or by fax at 410.597.0429. All fields below must be filled out.