NTIS Limited Access Death Master File Subscriber Certification Form

NTIS Limited Access Death Master File (LADMF) Subscriber Certification Form (Derived from the Social Security Administration's Death Master File)

OMB: 0692-0013

IC ID: 224474

Information Collection (IC) Details

View Information Collection (IC)

NTIS Limited Access Death Master File Subscriber Certification Form
 
No New
 
Mandatory
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form NTIS FM161 NTIS Limited Access Death Master File Subscriber Certification Form 0692-0013-NTIS-LADMF-SubscriberCertificationForm-NTIS FM161.pdf Yes Yes Fillable Fileable

General Government Central Records & Statistical Mgt

 

560 0
   
Individuals or Households
 
   100 %

  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 560 0 560 0 0 0
Annual IC Time Burden (Hours) 1,400 0 1,400 0 0 0
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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