Addendum to the Supporting Statement for
Form HA-504, Acknowledgement of Receipt (Notice of Hearing)
Form HA-L83, Acknowledgement of Receipt (Notice of Hearing) Cover Letter
Form HA-55, Objection to Appearing by Video Teleconferencing
Form HA-510 and HA-510-OP1, Waiver of Written Notice of Hearing
20 CFR 404.936, 404.938, 404.950, 416.1436, 416.1438, 416.1450
OMB No. 0960-0671
Revisions to the Collection Instrument
SSA is making the following revisions to this Information Collection Request:
Change #1: We are removing the one-time notice for pending claims
Justification #1: We completed processing the pending claims for which we sent the one-time notice. We are adjusting the burden accordingly.
Change #2: We are revising the Privacy Act Statements on the following forms: HA-504; HA-504-OP1; HA-510; and HA-55.
Justification #2: SSA’s Office of the General Counsel is conducting a systematic review of SSA’s Privacy Act Statements on agency forms. As a result, SSA is updating the Privacy Act Statements on these forms.
Change #3: We are adding the PRA statement to the HA-510.
Justification #2: We inadvertently did not include a PRA Statement on this form previously, and we are correcting that now.
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
| File Title | Addendum to the Supporting Statement for Form SSA-3462 |
| Author | 177717 |
| File Modified | 0000-00-00 |
| File Created | 2021-01-14 |