Information Collection

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

IC 224415 under ICR 201912-0692-001 · 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⚠️ Notice: This information collection may be referencing outdated material.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

Documents and forms in this information collection
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

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: Removed

Obligation to Respond: Voluntary

CFR Citation:

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	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 %

table that charts list of burden
	Change Due to Adjustment in Agency Estimate	Previously Approved
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

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.