Addendum - 0794

Addendum - 0794 (Final).docx

Request to Show Cause for Failure to Appear

Addendum - 0794

OMB: 0960-0794

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Addendum to the Supporting Statement for Form HA-L90

Request to Show Cause for Failure to Appear

20 CFR 404.938, 20 CFR 416.1438, and 20 CFR 404.957(b)(i) and (ii)

OMB No. 0960-0794


Minor Revisions to the Collection Instruments


SSA is making the following revisions:


  • Change #1: We changed all instances of “Office of Disability Adjudication and Review” to “Office of Hearings Operations” on both the HA-L90 and HA-L90-OP1.


Justification #1: We made this change due to the office name changing due to a reorganization.


  • Change #2: We are revising the PRA statements on these forms.


Justification #2: We are revising the PRA statements to reflect our current boilerplate language.  The current language, which dates back to the last reprint of the forms, is now outdated.


  • Change #3: We are revising the Privacy Act Statements on these forms.


Justification #3: 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.





File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
File TitleSupporting Statement For Form HA-539, Notice Regarding Substitution of Party Upon Death of Claimant
Author689830
File Modified0000-00-00
File Created2021-04-30

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