Information Collection

Request for Hearing By Administrative Law Judge, 20 CFR 404.933, 20 CFR 405.722

IC 9174 under ICR 200702-0960-007 · OMB 0960-0269.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0960-0269 can be found here:

Documents and Forms

Document Name Document Type
Form HA-501 Request for Hearing By Administrative Law Judge, 20 CFR 404.933, 20 CFR 405.722 Form
HA-501 Request for Hearing By Administrative Law Judge H501.pdf Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Request for Hearing By Administrative Law Judge, 20 CFR 404.933, 20 CFR 405.722	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation: 20 CFR 404.929 20 CFR 404.933 20 CFR 416.1429 20 CFR 404.1433 20 CFR 405.722 20 CFR 418.1350

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	HA-501	Request for Hearing By Administrative Law Judge	H501.pdf		No		Paper Only

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 669,469	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Previously Approved
Annual Number of Responses for this IC	669,469	669,469
Annual IC Time Burden (Hours)	111,578	111,578
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

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