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HA-L83 - Good Cause for Missing Deadline
Acknowledgement of Receipt (Notice of Hearing)
OMB: 0960-0671
IC ID: 209526
OMB.report
SSA
OMB 0960-0671
ICR 202410-0960-009
IC 209526
( )
Documents and Forms
Document Name
Document Type
HA-L83 - Revised Version.pdf
Other-Cover Letter and Instruction
HA-L83 - Current Version.pdf
Current HA-L83
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
HA-L83 - Good Cause for Missing Deadline
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Unchanged
Obligation to Respond:
Voluntary
CFR Citation:
20 CFR 404.936(f)(2)
20 CFR 416.1436(f)(2)
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Other-Cover Letter and Instruction
HA-L83 - Revised Version.pdf
No
Paper Only
Federal Enterprise Architecture Business Reference Module
Line of Business:
Income Security
Subfunction:
General Retirement and Disability
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
5,000
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
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
5,000
0
0
0
0
5,000
Annual IC Time Burden (Hours)
417
0
0
0
0
417
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Current HA-L83
HA-L83 - Current Version.pdf
08/08/2024
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.