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⚠️ Notice: This information collection may be referencing outdated material.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 Revised Version.pdf Form
HA-L83_Notice_of_Hearing[1].pdf HA-L83 (Cover Letter for the HA-504-OP1) IC Document
HA-504-OP1.pdf HA-504-OP1 Old Version 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: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 20 CFR 416.1438 20 CFR 404.938

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 Revised Version.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: 630,000	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	Previously Approved
Annual Number of Responses for this IC	630,000	90,000	540,000
Annual IC Time Burden (Hours)	315,000	45,000	270,000
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded
HA-L83 (Cover Letter for the HA-504-OP1)	HA-L83_Notice_of_Hearing[1].pdf	12/01/2010
HA-504-OP1 Old Version	HA-504-OP1.pdf	12/01/2010

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