PRA IC List
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Agenda
Reg Review
ICR
Information Collection List
IC Title
Status
Responses
Hours
Dollars
Document Type
Form No.
Form Name
Acknowledgement of Receipt (Notice of Hearing) - HA-504-OP1 (telephone hearing)
Removed
0
0
0
Form
HA-504-OP1
Acknowledgement of Receipt (Notice of Hearing)
Other-Cover Letter and Instruction
Claimant Enhanced Outreach - Follow Up Call – No Representative (Unrepresented Claimant/ProSe)
Removed
0
0
0
Other-Instructions and Call Flow for use by SSA Employees with Respondents
Claimant Enhanced Outreach - Follow up Call – With Representative
Removed
0
0
0
Other-Instructions and Call Flow for use by SSA Employees with Respondents
Claimant Enhanced Outreach - Initial Call No Representative (Unrepresented Claimant/ProSe)
Removed
0
0
0
Other-Instructions and Call Flow for use by SSA Employees with Respondents
Claimant Enhanced Outreach - Initial Call With Representative
Removed
0
0
0
Other-Instructions and Call Flow for use by SSA Employees with Respondents
Claimant Enhanced Outreach Call
Unchanged
75190
37595
0
Other-Call Script
Courtesy Copy of Remote Hearings Options Letter to Claimant
Removed
0
0
0
Other-Courtesy Copy of Cover Letter
HA-504 - Acknowledgement of Receipt (Notice of Hearing)
Unchanged
700000
350000
0
Form
HA-504
Acknowledgement of Receipt (Notice of Hearing)
Form
HA-504-OP1
Acknowledgement of Receipt (Notice of Hearing)
Form
HA-504-OP2
Acknowledgement of Receipt (Notice of Hearing)
HA-510 - Waiver of Timely Written Notice of Hearing
Unchanged
4000
133
0
Form
HA-510
Waiver of Timely Written Notice of Hearing
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)
Unchanged
500000
83333
0
Form
HA-55
Objection to Appearing by Video Teleconferencing
Form
HA-56
Agreement to Appearing by Online Video
Other-Cover Letter
HA-L2 - Acknowledgement Letter
Unchanged
500000
41667
0
Other-Cover Letter and Instruction
HA-L2 - Verification of New Residence
Unchanged
35000
2917
0
Other-Cover Letter
HA-L54 - Notification of objection to audio and agency video and agreement to online video more than 30-days after receipt of notice showing good cause
Unchanged
13500
2250
0
Other-Cover Letter
HA-L83 - Good Cause for Missing Deadline
Unchanged
5000
417
0
Other-Cover Letter and Instruction
HA-L83 - Notice of Hearing Cover Letter
Unchanged
700000
350000
0
Other-Cover Letter and Instruction
HA-L83 - Objection Stating Issues in Notice are Incorrect
Unchanged
35000
2917
0
Other-Cover Letter and Instruction
Microsoft Teams Video Hearing Call Script - Claimant Outreach
Removed
0
0
0
Other-Call Script
Microsoft Teams Video Hearing Call Script - Representative Payee Outreach
Removed
0
0
0
Other-Call Script
Remote Hearing Options Letter and Form Mailed to Representative
Removed
0
0
0
Form
N/A
Remote Hearing Notice and Agreement Form
Remote Hearings Options Follow up Call with Representative – no form
Removed
0
0
0
Total burden requested under this ICR:
2567690
871229
0
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