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Request to Show Cause for Failure to Appear - Redeterminations
Request to Show Cause for Failure to Appear
OMB: 0960-0794
IC ID: 229996
OMB.report
SSA
OMB 0960-0794
ICR 202012-0960-012
IC 229996
( )
Documents and Forms
Document Name
Document Type
Form HA-L90-OP1
Request to Show Cause for Failure to Appear - Redeterminations
Form
HA-L90-OP1 Request to Show Cause for Failure to Appear
HA-L90-OP1 - Revised.pdf
Form
HA-L90-OP1 - Current.pdf
HA-L90-OP1 - Current
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Request to Show Cause for Failure to Appear - Redeterminations
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 404.957
20 CFR 416.1438
20 CFR 404.938
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form
HA-L90-OP1
Request to Show Cause for Failure to Appear
HA-L90-OP1 - Revised.pdf
No
Fillable Printable
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:
500
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
80 %
Requested
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
500
0
0
0
0
500
Annual IC Time Burden (Hours)
83
0
0
0
0
83
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
HA-L90-OP1 - Current
HA-L90-OP1 - Current.pdf
04/28/2021
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
