Information Collection

Waiver of Your Right to Personal Appearance Before an Administrative Law Judge

IC 9188 under ICR 200703-0960-009 · OMB 0960-0284.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0960-0284 can be found here:

Documents and Forms

Document Name Document Type
Form HA-4608 Waiver of Your Right to Personal Appearance Before an Administrative Law Judge Form
HA-4608 Waiver of Right to Personal Appearance Before an Adminis HA-4608.pdf Form
PRA statement OHA Form.doc OHA PRA Statement IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Waiver of Your Right to Personal Appearance Before an Administrative Law Judge	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation: 20 CFR 416.1448(b)(1)(i) 20 CFR 404.948 (b)(1)(i)

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	HA-4608	Waiver of Right to Personal Appearance Before an Administrative Law Judge	HA-4608.pdf		Yes	No	Printable Only

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 12,000	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	12,000	12,000
Annual IC Time Burden (Hours)	400	400
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
OHA PRA Statement	PRA statement OHA Form.doc	03/30/2007

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