Information Collection

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

IC 180726 under ICR 201910-0960-002 · 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⚠️ Notice: This information collection may be referencing outdated material.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
iAppeals Revised Terms of Service - Clean Copy.docx	Other-Revised Terms of Service Scree
iAppeals Screens - i501.pdf www.ssa.gov/benefits/disability/appeal.html	Other-Current iAppeals Screens
iAppeals Screens - i501.pdf www.ssa.gov/benefits/disability/appeal.html	Other-Current iAppeals Screens

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

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-Current iAppeals Screens				https://www.ssa.gov/benefits/disability/appeal.html	Yes	Yes	Fillable Fileable Signable
Other-Revised Terms of Service Screen					Yes	Yes	Printable Only

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 653,318

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	653,318	-5,198	658,516
Annual IC Time Burden (Hours)	54,443	-433	54,876
Annual IC Cost Burden (Dollars)	0	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.

Something went wrong when downloading this file. If you have any questions, please send an email to [email protected].