Acknowledgement of Receipt (Notice of Hearing) - HA-504-OP1 (telephone hearing)

Acknowledgement of Receipt (Notice of Hearing)

OMB: 0960-0671

IC ID: 202942

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Form
Other-Cover Letter and Instruction
Other-Cover Letter and Instruction
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Acknowledgement of Receipt (Notice of Hearing) - HA-504-OP1 (telephone hearing)
 
No Unchanged
 
Required to Obtain or Retain Benefits
 
20 CFR 416.1450(a) 20 CFR 404.950(a) 20 CFR 416.1436(d), (e), and (f) 20 CFR 416.1438 20 CFR 404.936(d), (e), and (f) 20 CFR 404.938

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form HA-504-OP1 Acknowledgement of Receipt (Notice of Hearing) HA-504-OP1 - Revised Version.pdf No   Paper Only
Other-Cover Letter and Instruction HA-L83 - Current Telephone Version.pdf No   Paper Only

Income Security General Retirement and Disability

 

2,000 0
   
Individuals or Households
 
   0 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 2,000 0 0 0 0 2,000
Annual IC Time Burden (Hours) 1,000 0 0 0 0 1,000
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Current HA-504-OP1 HA-504-OP1 - Current Version.pdf 01/29/2021
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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