This online service allows you to electronically complete, sign, and submit the Waiver of Your Right to Personal Appearance Before a Judge (Form HA-4608). You may use this online service as an alternative to completing a paper version of this form. To complete the form online, you will need a valid email address.
Before beginning the form, you will need to enter and confirm your email address in the online application.
You will receive an email from firstname.lastname@example.org containing a link and instructions on how to access the form. The link will expire after five (5) calendar days. If the link expires, you will need to return to this page to request a new link.
IMPORTANT: We will not process the form until you complete the form, sign the form electronically, and select “Click to Sign” to submit the form. Upon submission, you will be able to download a copy of the signed form within the application. We recommend that you save a copy for your records. You will receive an email confirming your submission.
Sections 205(a), 1631(e), and 1869(b) of the Social Security Act, as amended, allow us to collect this information. Furnishing us this information is voluntary. However, failing to provide all or part may prevent us from making an accurate and timely decision on your claim. We will use the information you provide to continue processing the claim without an oral hearing. We may also share your information for the following purposes, called routine uses:
A list of additional routine uses is available in our Privacy Act System of Records Notices (SORN) 60-0009, entitled Hearing and Appeals Case Control System, as published in the Federal Register (FR) on October 13, 1982, at 47 FR 45589 and 60-0089, entitled Claims Folder System, as published in the FR on April 1, 2003, at 68 FR 15784. Additional information, and a full listing of all of our SORNs, is available on our website at www.ssa.gov/privacy.