State Death Match Collections

Forms and Documents

Document	Type	Status	Availability
Model MOU Anystate EDR.DOC	Supplementary Document	Uploaded 2008-03-19	Available
InfoExch Guidelines Version 30307.doc	Supplementary Document	Uploaded 2008-03-19	Available
Supporting Statement-edr 3-21-2008 (F).doc	Supporting Statement A	Uploaded 2008-03-28	Available

IC Document Collections

IC ID	Collection	Type	Status	Form
9754	State Death Match - Manual	Instruction	Modified
184171	One-Time Start-Up Fee for States Using EDR		New
184084	Electronic Death Registration	Other-Internet Screens for EDR	New

ICR Details

OMB Control No: 0960-0700	ICR Reference No: 200711-0960-002
Status: Historical Active	Previous ICR Reference No: 200502-0960-001
Agency/Subagency: SSA	Agency Tracking No:
Title: State Death Match Collections
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: 04/30/2008
	Date Received in OIRA: 03/28/2008
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	04/30/2011	36 Months From Approved	04/30/2008
Responses	2,650,019	0	1
Time Burden (Hours)	0	0	1
Cost Burden (Dollars)	51,562,000	0	17,114,000

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Abstract: Social Security uses the State Death Match Collections to ensure the accuracy of our payment files by detecting unreported or inaccurate death of beneficiaries. Under the Social Security Act entitlement to retirement, disability, wife's, husband's or parent's benefits terminates when the beneficiary dies. SSA is seeking clearance of both the current state death match reporting Process and the new Web-based Electronic Death Registration (EDR). The respondents to the collection are the State's bureaus of vital statistics.

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Authorizing Statute(s): US Code: 42 USC 405 Name of Law: null
   US Code: 42 USC 402 Name of Law: null
   US Code: 42 USC 403 Name of Law: null
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	72 FR 67776	11/30/2007
30-day Notice:	Federal Register Citation:	Citation Date:
	73 FR 16734	01/17/2008
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 3

IC Title	Form No.	Form Name
Electronic Death Registration
State Death Match - Manual
One-Time Start-Up Fee for States Using EDR

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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	2,650,019	1	0	0	2,650,018	0
Annual Time Burden (Hours)	0	1	0	0	-1	0
Annual Cost Burden (Dollars)	51,562,000	17,114,000	0	0	34,448,000	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: No

Burden Reduction Due to:

Short Statement: There are no program changes to this collection. However, there is an adjustment increase attributed to the start up costs for the 19 states that began using the EDR process since this ICR was last approved by OMB.

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Annual Cost to Federal Government: $9,488

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: 03/28/2008

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