Limited Access Death Master File (LADMF) Certification Systems Safeguards Attestation Form

Limited Access Death Master File Subscriber Certification Form

OMB: 0692-0014

IC ID: 214347

Information Collection (IC) Details

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Limited Access Death Master File (LADMF) Certification Systems Safeguards Attestation Form
 
No New
 
Required to Obtain or Retain Benefits
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form NTIS FM100 Limited Access Death Master File (LADMF) Certification Systems Safeguards Attestation Form DMF Attestation Form Final to ROCIS 121914.pdf Yes Yes Fillable Fileable

General Government Central Records & Statistical Mgt

 

550 0
   
Individuals or Households
 
   100 %

  Requested 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 550 0 550 0 0 0
Annual IC Time Burden (Hours) 1,100 0 1,100 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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