Health IT Partner Assessment - SSA-680

SSA Health IT Partner Assessment - Participating Facilities and Available Content Form, SSA-680

OMB: 0960-0798

IC ID: 201618

Information Collection (IC) Details

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Health IT Partner Assessment - SSA-680
 
No New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form SSA-680 Health IT Partner Assessment SSA-680.xlsx Yes Yes Fillable Fileable

Income Security General Retirement and Disability

 

30 0
   
Private Sector Businesses or other for-profits
 
   100 %

  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 0 30 0 0 0
Annual IC Time Burden (Hours) 150 0 150 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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