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⚠️ Notice: This information collection may be referencing outdated material.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

Documents and forms in this information collection
Document Name	Document Type
Form HA-4608 Waiver of Right to Personal Appearance Before an Administrative Law Judge 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

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:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	HA-4608				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 %

table that charts list of burden
	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

table that charts IC Documents
Title	Document	Date Uploaded
OHA PRA Statement		03/30/2007

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

Something went wrong when downloading this file. If you have any questions, please send an email to [email protected].