Electronic Death Registration Survey

Forms and Documents

Document	Type	Status	Availability

No forms / supporting documents in this ICR. Check IC Document Collections.

IC Document Collections

IC ID	Collection	Type	Status	Form
9644	Electronic Death Registration Survey		Migrated

ICR Details

OMB Control No: 0960-0625	ICR Reference No: 200202-0960-001
Status: Historical Active	Previous ICR Reference No: 200112-0960-002
Agency/Subagency: SSA	Agency Tracking No:
Title: Electronic Death Registration Survey
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 02/28/2002
	Date Received in OIRA: 02/05/2002
Terms of Clearance: Approved. OMB and SSA have agreed that the survey form will remain on the internet in between data-collection waves, for those states that take the initiative to update their surveys prior to the next wave of data collection. However, when SSA undertakes the next wave, they will send out emails to the States informing them of the survey, the need to update their answers, and the necessity of the update (to be used for funding decisions). SSA shall provide a copy of the email to OMB as soon as it is ready. Prior to the agency sending out the email to the States, SSA will provide information to OMB on timeframe and will also provide an updated email, if any changes have been made. (This is consistent with SSA memo dated 2/11/02).

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	02/28/2005	02/28/2005	02/28/2002
Responses	55	0	55
Time Burden (Hours)	28	0	110
Cost Burden (Dollars)	0	0	0

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Abstract: Section 205(R) requires SSA to enter into agreements with States to obtain death records. Section 202(a)(1)-(h)(1) require SSA to terminate Retirement, Survivors and Disability benefits upon the death of the beneficiary. This survey will measure the States' readiness to implement electronic death registration processes which will result in SSA getting death information more timely and accurately to terminate benefits as required by law.

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Authorizing Statute(s): None

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:

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Federal Register Notices & Comments

Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
Electronic Death Registration Survey

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ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	55	55	0	0	0	0
Annual Time Burden (Hours)	28	110	0	-82	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: Yes

Burden Reduction Due to:

Short Statement:

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Annual Cost to Federal Government: $0

Does this IC contain surveys, censuses, or employ statistical methods? No

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? Uncollected

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? Uncollected

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? Uncollected

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 02/05/2002

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