NDI Early Release Fee Worksheet

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

Att F2 Early Release Fee Worksheet 120619.xls

NDI - Early Release Fee Worksheet

OMB: 0920-0215

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Early Release NDI FEE WORKSHEET (2018)








CDC estimates the average public reporting burden for this collection of information as 2 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data/information needed, and completing and reviewing the collection of information. An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to CDC/ATSDR Information Collection Review Office; 1600 Clifton Road NE, MS D–74, Atlanta, GA 33033, ATTN: PRA (0929–0215).
NDI Plus Search: UNKNOWN Vital Status
















First Year Searched Last Year Searched Number of Years Searched
Number of Subjects
NDI Fee*
NDI Charge
2018 2018 1 X 0 X $0.21 = $0.00



Subtotal 0

Subtotal $0.00
* Use $0.15 per year if you are only doing a ROUTINE NDI search.
















NDI Plus Search: KNOWN Decedents




















Number of Subjects
NDI Fee
NDI Charge
Death certificates have NOT been obtained


0 X $5.00 = $0.00
Death certificates have been obtained


0 X $2.50 = $0.00



Subtotal 0

Subtotal $0.00












Total Records 0












Service Charge:







$350 for INITIAL search or $100 for REPEAT searches





Service Charge** $0.00









** This charge covers all files submitted at one time.





Total $0.00
File Typeapplication/vnd.ms-excel
Authorhbw4
Last Modified BySusan's comments
File Modified2020-01-10
File Created2007-07-06

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