NDI - Application Form (paper)

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

OMB: 0920-0215

IC ID: 6683

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NDI - Application Form (paper)
 
No Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction n/a National Death Index Application Form Att C1 Application Form Paper_121219.docx No   Paper Only

Health Public Health Monitoring

09-20-0166 Vital Statistics for Births, Deaths, Fetal Deaths, Marriages and Divorces Occurring in the US During Each Year  49 FR 37695

10 0
   
Individuals or Households
 
   0 %

  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 10 0 -90 0 100 0
Annual IC Time Burden (Hours) 30 0 -370 0 400 0
Annual IC Cost Burden (Dollars) 1,237 0 1,237 0 0 0

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