Information Collection Request

Acknowledgement of Receipt (Notice of Hearing)

ICR 201912-0960-006 · OMB 0960-0671 · Historical Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form HA-504 Acknowledgement of Receipt (Notice of Hearing) Form Unchanged Available
Form HA-510-OP1 Option to Accept an Earlier Hearing Waiver of Timely Written Notice of Hearing Form Modified Available
Form HA-510 Waiver of Written Notice of Hearing Form Modified Available
Form HA-55 Objection to Appearing by Video Teleconferencing Form and Instruction Modified Available
Form HA-504-OP1 Acknowledgement of Receipt (Notice of Hearing) Form Unchanged Available
Justification for Non-Substantive Changes for 0960-0671.docx Justification for No Material/Nonsubstantive Change Uploaded 2019-12-20 Available
Addendum - 0671.docx Supplementary Document Uploaded 2017-07-14 Available
Supporting Statement - 0671.docx Supporting Statement A Uploaded 2017-07-14 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
9725 Acknowledgement of Receipt (Notice of Hearing) - HA-504 (with teleconferencing) Form UnchangedAcknowledgement of Receipt (Notice of Hearing)
9725 Acknowledgement of Receipt (Notice of Hearing) - HA-504 (with teleconferencing) Other-Cover Letter Unchanged
209530 Objection Stating Issues in Notice are Incorrect - HA-L83 Other-Cover Letter Unchanged
209529 Late Notification of Objection to Video Teleconference Showing Good Cause - HA-2 Other-Cover Letter Unchanged
209528 Verification of New Residence - HA-L2 Other-Cover Letter Unchanged
209527 Waiver of Written Notice of Hearing - HA-510 Form ModifiedOption to Accept an Earlier Hearing Waiver of Timely Written Notice of Hearing
209527 Waiver of Written Notice of Hearing - HA-510 Form ModifiedWaiver of Written Notice of Hearing
209526 Good Cause for Missing Deadline - HA-L83 Other-Cover Letter Unchanged
209525 Notice of Hearing Cover Letter - HA-L83 Other-Cover Letter Unchanged
209524 Objection to Appearing by Video Teleconferencing - HA-55 Form and Instruction ModifiedObjection to Appearing by Video Teleconferencing
209524 Objection to Appearing by Video Teleconferencing - HA-55 Other-Cover Letter Modified
202942 Acknowledgement of Receipt (Notice of Hearing) - HA-504-OP1 (telephone hearing) Form UnchangedAcknowledgement of Receipt (Notice of Hearing)
202942 Acknowledgement of Receipt (Notice of Hearing) - HA-504-OP1 (telephone hearing) Other-Cover Letter Unchanged

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
02/28/2021 02/28/2021 02/28/2021
2,762,500 0 2,762,500
981,133 0 981,133
0 0 0





Reginfo record details
9
table that charts list of burden
IC Title Form No. Form Name
Acknowledgement of Receipt (Notice of Hearing) - HA-504 (with teleconferencing) HA-504
Acknowledgement of Receipt (Notice of Hearing) - HA-504-OP1 (telephone hearing) HA-504-OP1
Good Cause for Missing Deadline - HA-L83
Late Notification of Objection to Video Teleconference Showing Good Cause - HA-2
Notice of Hearing Cover Letter - HA-L83
Objection Stating Issues in Notice are Incorrect - HA-L83
Objection to Appearing by Video Teleconferencing - HA-55 HA-55
Verification of New Residence - HA-L2
Waiver of Written Notice of Hearing - HA-510 HA-510, HA-510-OP1 ,  

table that charts list of burden
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 2,762,500 2,762,500 0 0 0 0
Annual Time Burden (Hours) 981,133 981,133 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No