OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

Request for Hearing By Administrative Law Judge--Paper/MCS/MSSICS Versions

IC 9174 under ICR 201404-0960-015 · OMB 0960-0269.

Documents and Forms
Document Name
Document Type
Form and Instruction
Other-Internal MSSICS Screens
Other-Internal MCS Screens
Form and Instruction
IC Document
IC Document
IC Document
Information Collection (IC) Details

View Information Collection (IC)

Request for Hearing By Administrative Law Judge--Paper/MCS/MSSICS Versions
 
No Modified
 
Required to Obtain or Retain Benefits
 
20 CFR 404.933 20 CFR 418.1350 20 CFR 404.929 20 CFR 405.722 20 CFR 416.1429 20 CFR 404.1433

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction HA-501 Request for Hearing By Administrative Law Judge HA-501 - Revised Version.pdf No   Paper Only
Other-Internal MSSICS Screens HA-501 - Revised MSSICS Screens.pdf Yes Yes Fillable Fileable Signable
Other-Internal MCS Screens HA-501 - Revised MCS Screens.pdf Yes Yes Fillable Fileable Signable

Income Security General Retirement and Disability

 

25,953 0
   
Individuals or Households
 
   95 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 25,953 0 0 0 0 25,953
Annual IC Time Burden (Hours) 4,326 0 0 0 0 4,326
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Current HA-501 HA-501 - Current Version.pdf 07/23/2014
Current HA-501 MSSICS Screens HA-501 - Current MSSICS Screens.pdf 07/23/2014
Current HA-501 MCS Screens HA-501 - Current MCS Screens.pdf 07/23/2014
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.