View Information Collection (IC)
View Information Collection (IC)

View Information Collection (IC)

20 CFR 404.971 and 416.1471 (Request to Withdraw a Hearing Request; Request to Withdraw an Appeals Council Request for Review)
 
No Modified
 
Required to Obtain or Retain Benefits
 
20 CFR 404.971 and 416.1471

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form HA-85 No   Paper Only
Form HA-86 No   Paper Only
Other-Revised PA Statement No   Paper Only
Other-Revised PA Statement No   Paper Only

Income Security General Retirement and Disability

 

1,606 0
   
Individuals or Households
 
   0 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 1,606 0 0 0 0 1,606
Annual IC Time Burden (Hours) 268 0 0 0 0 268
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
HA-85 - Current 07/19/2016
HA-86 - Current 07/19/2016
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
Something went wrong when downloading this file. If you have any questions, please send an email to risc@gsa.gov.