Claimant's Statement When Request For Hearing Is Filed And The Issue Is Disability

CLAIMANT'S STATEMENT WHEN REQUEST FOR HEARING IS FILED AND THE ISSUE IS DISABILITY

OMB: 0960-0316

IC ID: 115291

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CLAIMANT'S STATEMENT WHEN REQUEST FOR HEARING IS FILED AND THE ISSUE IS DISABILITY
 
No Migrated
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form HA-4486 No No


    

271,000 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 271,000 0 -29,000 0 0 300,000
Annual IC Time Burden (Hours) 67,750 0 -7,250 0 0 75,000
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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