Acknowledgement of Receipt (Notice of Hearing)--HA-504-OP1 (without teleconferencing)

Acknowledgement of Receipt (Notice of Hearing)

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0960-0671 can be found here:

Documents and Forms

Document Name Document Type
Form HA-504-OP1 Acknowledgement of Receipt (Notice of Hearing)--HA-504-OP1 (without teleconferencing) Form
HA-504-OP1 Acknowledgement of Receipt (Notice of Hearing) HA-504-OP1.pdf Form
HA-L83 Notice of Hearing.pdf HA-L83 (Cover Letter for the HA-504-OP1) IC Document

Information Collection (IC) Details

IC Title:	Acknowledgement of Receipt (Notice of Hearing)--HA-504-OP1 (without teleconferencing)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 20 CFR 404.938 20 CFR 416.1438

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	HA-504-OP1	Acknowledgement of Receipt (Notice of Hearing)	HA-504-OP1.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: 540,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Change Due to Adjustment in Agency Estimate
Annual Number of Responses for this IC	540,000	540,000
Annual IC Time Burden (Hours)	270,000	270,000
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
HA-L83 (Cover Letter for the HA-504-OP1)	HA-L83 Notice of Hearing.pdf	02/25/2008

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