Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Acknowledgement of Receipt (Notice of Hearing) - HA-504 (with teleconferencing) Unchanged 898000 449000 0 Form HA-504
Form HA-504-OP2
Other-Cover Letter and Instructions
Other-Cover Letter and Instructions
Acknowledgement of Receipt (Notice of Hearing) - HA-504-OP1 (telephone hearing) Unchanged 2000 1000 0 Form HA-504-OP1
Other-Cover Letter and Instruction
Claimant Enhanced Outreach - Follow Up Call – No Representative (Unrepresented Claimant/ProSe) Modified 37500 37500 0 Other-Instructions and Call Flow for use by SSA Employees with Respondents
Claimant Enhanced Outreach - Follow up Call – With Representative Modified 120800 60400 0 Other-Instructions and Call Flow for use by SSA Employees with Respondents
Claimant Enhanced Outreach - Initial Call No Representative (Unrepresented Claimant/ProSe) Modified 75190 12532 0 Other-Instructions and Call Flow for use by SSA Employees with Respondents
Claimant Enhanced Outreach - Initial Call With Representative Modified 201400 33567 0 Other-Instructions and Call Flow for use by SSA Employees with Respondents
Courtesy Copy of Remote Hearings Options Letter to Claimant Modified 280000 9333 0 Other-Courtesy Copy of Cover Letter
Good Cause for Missing Deadline - HA-L83 Unchanged 5000 417 0 Other-Cover Letter and Instruction
Other-Cover Letter and Instruction
Other-Cover Letter and Instruction
Late Notification of Objection to Video Teleconference Showing Good Cause - HA-2 Unchanged 13500 2250 0 Other-Cover Letter and Instruction
Microsoft Teams Video Hearing Call Script - Claimant Outreach Unchanged 50 17 0 Other-Call Script
Microsoft Teams Video Hearing Call Script - Representative Payee Outreach Unchanged 50 17 0 Other-Call Script
Notice of Hearing Cover Letter - HA-L83 Unchanged 900000 450000 0 Other-Cover Letter and Instruction
Other-Cover Letter and Instruction
Other-Cover Letter and Instruction
Objection Stating Issues in Notice are Incorrect - HA-L83 Unchanged 45000 3750 0 Other-Cover Letter and Instruction
Other-Cover Letter and Instruction
Other-Cover Letter and Instruction
Objection to Appearing by Video Teleconferencing - HA-55 Unchanged 850000 70833 0 Form HA-55
Other-Cover Letter and Instruction
Remote Hearing Options Letter and Form Mailed to Representative Modified 280000 46667 0 Form N/A
Remote Hearings Options Follow up Call with Representative – no form Modified 70000 5833 0
Verification of New Residence - HA-L2 Unchanged 45000 3750 0 Other-Cover Letter and Instruction
Waiver of Written Notice of Hearing - HA-510 Unchanged 4000 133 0 Form HA-510
Form HA-510-OP1
Other-Revised PA and PRA Statements
Total burden requested under this ICR: 3827490 1186999 0  
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