Information Collection

HA-510 - Waiver of Timely Written Notice of Hearing

IC 209527 under ICR 202410-0960-009 · OMB 0960-0671.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form HA-510 Waiver of Timely Written Notice of Hearing HA-510 - Waiver of Timely Written Notice of Hearing	Form
HA-510 Waiver of Timely Written Notice of Hearing HA-510 - Revised Version.pdf	Form
HA-510 - Current Version.pdf Currently Approved HA-510	IC Document

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Unchanged

Obligation to Respond: Voluntary

CFR Citation: 20 CFR 416.1438(a) 20 CFR 404.938(a)

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	HA-510				No		Paper Only

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 4,000

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	4,000	4,000
Annual IC Time Burden (Hours)	133	133
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Currently Approved HA-510		08/08/2024

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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