HA-510 - Waiver of Timely Written Notice of Hearing

Acknowledgement of Receipt (Notice of Hearing)

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0960-0671 can be found here:

Documents and Forms

Document Name Document Type
Form HA-510 HA-510 - Waiver of Timely Written Notice of Hearing Form
HA-510 Waiver of Timely Written Notice of Hearing HA-510 - Revised Version.pdf Form
HA-510 Waiver of Timely Written Notice of Hearing HA-510 - Revised Version.pdf Form
HA-510 - Current Version.pdf Currently Approved HA-510 IC Document
HA-510 - Current Version.pdf Currently Approved HA-510 IC Document

Information Collection (IC) Details

IC Title:	HA-510 - Waiver of Timely Written Notice of Hearing	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation: 20 CFR 404.938(a) 20 CFR 416.1438(a)

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	HA-510	Waiver of Timely Written Notice of Hearing	HA-510 - Revised Version.pdf		No		Paper Only

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 4,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Requested	Previously Approved
Annual Number of Responses for this IC	4,000	4,000
Annual IC Time Burden (Hours)	133	133
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Currently Approved HA-510	HA-510 - Current Version.pdf	08/08/2024

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.