OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

HA-55 (Objection to Appearing by Audio or Agency video); HA-56 (Agreement to Appearing by Online Video); HA-L54 (Notice of Ways to Attend a Hearing)

IC 209524 under ICR 202410-0960-009 · OMB 0960-0671.

Documents and Forms
Document Name
Document Type
Form
Other-Cover Letter
Form
Form
IC Document
Information Collection (IC) Details

View Information Collection (IC)

HA-55 (Objection to Appearing by Audio or Agency video); HA-56 (Agreement to Appearing by Online Video); HA-L54 (Notice of Ways to Attend a Hearing)
 
No Unchanged
 
Required to Obtain or Retain Benefits
 
20 CFR 416.1438 20 CFR 404.936 20 CFR 404.938 20 CFR 416.1436

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form HA-55 Objection to Appearing by Video Teleconferencing HA-55 -Revised Version.pdf No   Paper Only
Form HA-56 Agreement to Appearing by Online Video HA-56.pdf No   Paper Only
Other-Cover Letter HA-L54.pdf No   Paper Only

Income Security General Retirement and Disability

 

500,000 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 500,000 0 0 -350,000 0 850,000
Annual IC Time Burden (Hours) 83,333 0 12,500 0 0 70,833
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Currently Approved HA-55 HA-55 - Current Version.pdf 08/08/2024
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.