Information Collection

Application Form and Related Forms for the Operation of the National Death Index

IC 6681 under ICR 199808-0920-003 · OMB 0920-0215.

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Documents and Forms

Documents and forms in this information collection
Document Name	Document Type

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IC Title:

Application Form and Related Forms for the Operation of the National Death Index

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Migrated

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Available Electronically?	Can Be Submitted Electronically?
Form	CDC/NCHS-6205-1	No	No
Form	CDC-6424	No	No
Form	PHS-6205-3	No	No
Form	CDC-6426	No	No
Form	CDC-6425	No	No

Line of Business:

Subfunction:

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 120

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	780	780
Annual IC Time Burden (Hours)	227	227
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded

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

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