Acknowledgement of Receipt (Notice of Hearing) - HA-504 (with teleconferencing)

Acknowledgement of Receipt (Notice of Hearing)

OMB: 0960-0671

IC ID: 9725

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Information Collection (IC) Details

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Acknowledgement of Receipt (Notice of Hearing) - HA-504 (with teleconferencing)
 
No Unchanged
 
Required to Obtain or Retain Benefits
 
20 CFR 416.1438 20 CFR 404.938

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form HA-504 Acknowledgement of Receipt (Notice of Hearing) HA-504 - Revised Version.pdf No   Paper Only
Form HA-504-OP2 ACKNOWLEDGEMENT OF RECEIPT (NOTICE OF HEARING) HA-504-OP2 - Revised Version.pdf No   Paper Only
Other-Cover Letter and Instructions HA-L83 - Current Version (Non COVID-related).pdf No   Paper Only
Other-Cover Letter and Instructions HA-L83 - Current MS Teams Version.pdf No   Paper Only

Income Security General Retirement and Disability

 

898,000 0
   
Individuals or Households
 
   0 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 898,000 0 0 0 0 898,000
Annual IC Time Burden (Hours) 449,000 0 0 0 0 449,000
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Current HA-504 HA-504 - Current Version.pdf 01/29/2021
Current HA-504-OP2 HA-504-OP2 - Current Version.pdf 01/29/2021
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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