Information Collection Request
Request for Hearing By Administrative Law Judge
ICR 202412-0960-004 · OMB 0960-0269 · Received in OIRA
Forms and Documents
| Document | Type | Status | Availability |
|---|---|---|---|
 Form HA-501 Request for Hearing By Administrative Law Judge--Paper/MCS/MSSICS Versions |
Form and Instruction | Modified | Repair queued |
 Addendum - 0269.docx |
Supplementary Document | Uploaded 2025-03-21 | Repair queued |
| Supporting Statement - 0269.docx |
Supporting Statement A | Uploaded 2025-03-21 | Repair queued |
IC Document Collections
| IC ID | Collection | Type | Status | Form |
|---|---|---|---|---|
| 9174 |  Request for Hearing By Administrative Law Judge--Paper/MCS/MSSICS Versions |
Form and Instruction | Modified | |
| 180726 | Request for Hearing By Administrative Law Judge--Internet Version (i501) |
Other-Current iAppeals Screens | Modified |
ICR Details
| Status | Received in OIRA |
|---|---|
| Agency/Subagency | SSA |
| OMB Control No | 0960-0269 |
| Type of Information Collection | Revision of a currently approved collection |
| Previous ICR Reference No | 201910-0960-002 |
| Date Submitted to OIRA | 1969-12-31 |
| Requested Expiration Date | 1969-12-31 |