Get Ha-501-u5. Request For Hearing By Administrative Law Judge

The HA-501-U5 form is a crucial document for individuals seeking a hearing before an administrative law judge regarding their Social Security claims. This guide provides clear, step-by-step instructions to help you successfully complete this form online.

Follow the steps to fill out the HA-501-U5 form online.

1. Click ‘Get Form’ button to obtain the HA-501-U5 form and open it for online completion.
2. Fill in the claimant's name in the designated field. Additionally, provide the claimant's Social Security number (SSN) for identification purposes.
3. If the claimant has a different claim number, enter it in the provided space.
4. Input the wage earner's name, if applicable, in the appropriate section. If the wage earner is different, add their corresponding SSN.
5. Indicate your spouse's name if they are not the wage earner. Also, fill in the spouse’s claim number or SSN if applicable.
6. In the section labeled 'I request a hearing before an administrative law judge,' clearly state why you disagree with the determination made regarding your claim.
7. Indicate whether you have additional evidence to submit by checking 'Yes' or 'No.' If 'Yes,' provide the name and address of the source of this evidence.
8. Select whether you wish to appear at the hearing or prefer a decision to be made based on submitted evidence. If you choose not to appear, complete the accompanying waiver form HA-4608.
9. Sign and date the form in the designated 'Claimant's Signature' section. Ensure your address, phone number, and fax number are entered accurately.
10. If you have a representative, they should complete their information in the 'Representative's Signature' section. If they are unavailable, you may provide that information as well.
11. Once all fields are completed, review your form for accuracy. You can then save your changes, download, print, and share the completed document as required.

Ready to submit your request? Complete your HA-501-U5 form online today!