Information Collection

Late Notification of Objection to Video Teleconference Showing Good Cause - HA-2

IC 209529 under ICR 201705-0960-004 · OMB 0960-0671.

⚠️ Notice: This information collection may be referencing outdated material.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

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form HA-2 Objection to Video Teleconferencing – Request to Show Cause Late Notification of Objection to Video Teleconference Showing Good Cause - HA-2	Form and Instruction
HA-L83 - Notice of Hearing - Cover Letter.pdf	Other-Cover Letter
HA-2 Objection to Video Teleconferencing – Request to Show Ca HA-2 - New Form (Good Cause).pdf	Form and Instruction

IC Title:

Late Notification of Objection to Video Teleconference Showing Good Cause - HA-2

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Unchanged

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 20 CFR 405.317(a)(2) 20 CFR 416.1436(d)(2) 20 CFR 404.936(c)(2)

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
Other-Cover Letter					No		Paper Only
Form and Instruction	HA-2				No		Paper Only

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 13,500

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	13,500	13,500
Annual IC Time Burden (Hours)	2,250	2,250
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

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

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