Information Collection

Report of Death by Funeral Director

IC 37956 under ICR 200807-0960-005 · OMB 0960-0142.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0960-0142 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form SSA-721 Report of Death by Funeral Director	Form and Instruction
SSA-721 Statement of Death by Funeral Director Form SSA-721 (0960-0142).pdf	Form and Instruction

IC Title:

Report of Death by Funeral Director

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation: 20 CFR 404.715 20 CFR 404.720

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	SSA-721	Statement of Death by Funeral Director	Form SSA-721 (0960-0142).pdf		No		Paper Only

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 319,811

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	319,811	-409,950	729,761
Annual IC Time Burden (Hours)	18,656	-23,913	42,569
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

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