National Death Index - Transmittal Form

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

OMB: 0920-0215

IC ID: 182824

Information Collection (IC) Details

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National Death Index - Transmittal Form
 
No Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form 0920-0215 Transmittal Form NDI NEW Att D Trans.pdf none Yes Yes Fillable Printable

Health Public Health Monitoring

 

120 5
   
State, Local, and Tribal Governments
 
   20 %

  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 120 0 0 0 0 120
Annual IC Time Burden (Hours) 36 0 0 0 0 36
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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

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