Information Collection

Request for Hearing By Administrative Law Judge--Internet Version (i501)

IC 180726 under ICR 202412-0960-004 · OMB 0960-0269.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
iAppeals Screens - i501 (revised).pdf www.ssa.gov/benefits/disability/appeal.html	Other-Current iAppeals Screens
iAppeals Revised Terms of Service - Clean Copy.docx	Other-Revised Terms of Service Scree
iAppeals Screens - i501 (current).pdf iAppeals Screens - i501 (current)	IC Document

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 20 CFR 404.929 20 CFR 418.1350 20 CFR 404.933 20 CFR 416.1429 20 CFR 405.722 20 CFR 416.1433

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
Other-Current iAppeals Screens				https://www.ssa.gov/benefits/disability/appeal.html	Yes	Yes	Fillable Fileable Signable
Other-Revised Terms of Service Screen					Yes	Yes	Printable Only

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 281,819

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Requested	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	281,819	-371,499	653,318
Annual IC Time Burden (Hours)	140,910	86,467	54,443
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
iAppeals Screens - i501 (current)		03/21/2025

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

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