Information Collection

NTIS Limited Access Death Master File Accredited Conformity Assessment Body Application Form for Firewalled

IC 224415 under ICR 201611-0692-001 · OMB 0692-0015.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0692-0015 can be found here:

Documents and Forms

Document Name Document Type
Form NTIS FM101 NTIS Limited Access Death Master File Accredited Conformity Assessment Body Application Form for Firewalled Form
NTIS FM101 NTIS Limited Access Death Master File Accredited Conform 0692-XXXX-NTIS-LADMF-FirewalledStatusApplication.pdf Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	NTIS Limited Access Death Master File Accredited Conformity Assessment Body Application Form for Firewalled	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	NTIS FM101	NTIS Limited Access Death Master File Accredited Conformity Assessment Body Application Form for Firewalled Status	0692-XXXX-NTIS-LADMF-FirewalledStatusApplication.pdf		Yes	Yes	Fillable Fileable

Line of Business: General Government

Subfunction: Central Records & Statistical Mgt

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 112	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 80 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	112	112
Annual IC Time Burden (Hours)	112	112
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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.