Information Collection

Request for Hearing By Administrative Law Judge--Internet Version (i501)

IC 180726 under ICR 201102-0960-007 · 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⚠️ Notice: This information collection may be referencing outdated material.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

Documents and forms in this information collection
Document Name	Document Type
Form i501 (Internet Ver Request for Hearing By Administrative Law Judge--Internet Version (i501)	Form and Instruction
i501 (Internet Ver Request for Hearing By Administrative Law Judge iAppeals Screens (Revised).pdf	Form and Instruction
iAppeals_Screens (current).pdf i501 screens (current)	IC Document

IC Title:

Request for Hearing By Administrative Law Judge--Internet Version (i501)

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 416.1433 20 CFR 404.933 20 CFR 416.1429 20 CFR 405.722 20 CFR 418.1350 20 CFR 404.929

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 and Instruction	i501 (Internet Version of HA-501)	Request for Hearing By Administrative Law Judge	iAppeals Screens (Revised).pdf		Yes	Yes	Fillable Fileable Signable

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 635,996

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 95 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	635,996	301,262	334,734
Annual IC Time Burden (Hours)	201,399	95,400	105,999
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
i501 screens (current)	iAppeals_Screens (current).pdf	05/31/2011

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