Remote Hearing Options Letter and Form Mailed to Representative

Acknowledgement of Receipt (Notice of Hearing)

Documents and Forms

Document Name Document Type
Remote Hearing Options Letter and Form Mailed to Representative Form
Remote Hearing Notice and Agreement Form Remote Hearing Options - Revised Version (COVID-19 Language Removed).docx Form
COVID-19 Remote Hearing Options - Current Version.docx Current COVID-19 Notice and Form IC Document

Information Collection (IC) Details

IC Title:	Remote Hearing Options Letter and Form Mailed to Representative	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Removed

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 20 CFR 404.938 20 CFR 416.1436 20 CFR 416.1438 20 CFR 404.936

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	N/A	Remote Hearing Notice and Agreement Form	Remote Hearing Options - Revised Version (COVID-19 Language Removed).docx		No		Fillable Fileable Signable

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 280,000	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	-280,000	280,000
Annual IC Time Burden (Hours)	-46,667	46,667
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Current COVID-19 Notice and Form	COVID-19 Remote Hearing Options - Current Version.docx	04/04/2023

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.