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Request to Decision Review Board to Vacate the Administrative law Judge Dismissal of Hearing.
Request to Decision Review Board to Vacate the Administrative law Judge Dismissal of Hearing.
OMB: 0960-0755
IC ID: 179449
OMB.report
SSA
OMB 0960-0755
ICR 201004-0960-011
IC 179449
( )
Documents and Forms
Document Name
Document Type
Form SSA-525
Request to Decision Review Board to Vacate the Administrative law Judge Dismissal of Hearing.
Form
SSA-525 Request to Decision Review Board to Vacate the Administr
SSA-525 Final.pdf
Form
S525.pdf Current Version of SSA-525
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Request to Decision Review Board to Vacate the Administrative law Judge Dismissal of Hearing.
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Modified
Obligation to Respond:
Voluntary
CFR Citation:
20 CFR 405.382
20 CFR 405.427
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form
SSA-525
Request to Decision Review Board to Vacate the Administrative law Judge Dismissal of Hearing.
SSA-525 Final.pdf
No
Paper Only
Federal Enterprise Architecture Business Reference Module
Line of Business:
Income Security
Subfunction:
General Retirement and Disability
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
30,000
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
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
30,000
0
0
0
0
30,000
Annual IC Time Burden (Hours)
5,000
0
0
0
0
5,000
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Current Version of SSA-525
S525.pdf
08/16/2010
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.