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

ICR 202001-0692-001

OMB: 0692-0013

Federal Form Document

IC Document Collections
ICR Details
0692-0013 202001-0692-001
Active 201908-0692-002
DOC/NTIS ML
NTIS Limited Access Death Master File (LADMF) Certification Form (Derived from the Social Security Administration's Death Master File)
Revision of a currently approved collection   No
Regular
Approved with change 03/25/2020
Retrieve Notice of Action (NOA) 01/30/2020
This collection is approved based on the revised materials provided by the Department.
  Inventory as of this Action Requested Previously Approved
03/31/2023 36 Months From Approved 03/31/2020
250 0 560
625 0 1,400
0 0 0

To collect information necessary to support the certification process required by Section 203 of the Bipartisan Budget Act of 2013 (Pub. L. 113-67) for members of the public to be given access to the Death Master File containing information about deceased persons during the three-calendar-year period after that person's death.

PL: Pub.L. 113 - 67 203 Name of Law: Bipartisan Budget Act of 2013
  
None

Not associated with rulemaking

  84 FR 64872 11/25/2019
85 FR 5202 01/29/2020
No

1
IC Title Form No. Form Name
NTIS Limited Access Death Master File Subscriber Certification Form NTIS FM161 Limited Access Death Master File Certification Form

  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 250 560 0 -310 0 0
Annual Time Burden (Hours) 625 1,400 0 -775 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
Yes
Miscellaneous Actions
Since NTIS estimates that 250 respondents each year will submit the form, the total annual cost to the public will be $795,000 ($732,500 in fees + $62,500 in staff time = $795,000).

$62,500
No
    No
    No
No
No
No
Uncollected
Daniel Ramsey 703 605-6703 [email protected]

  No

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
01/30/2020


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