Statement of Death by Funeral Director and State Death Match

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form SSA-721 Statement of Death by Funeral Director	Form and Instruction	Modified	Available
Form SSA-721 Report of Death by Funeral Director	Form and Instruction	Modified	Available
Addendum - 0142.docx	Supplementary Document	Uploaded 2024-05-09	Repair queued
Supporting Statement - 0142.docx	Supporting Statement A	Uploaded 2024-05-09	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
37956	Report of Death by Funeral Director	Form and Instruction	Modified	Statement of Death by Funeral Director
37956	Report of Death by Funeral Director	Form and Instruction	Modified
256495	State Death Match - States Expected to Become EDR's within next 3 Year	Other-Death Screen Images	Modified
256494	State Death Match - Electronic Death Registration (EDR)	Other-Death Screen Images	Modified
256493	State Death Match - Manual - Non-EDR	Other-Instructions and File Format for State's Use	Removed
256492	State Death Match - Manual - Non-EDR Records from EDR sites	Other-ile Format for State's Use	Removed

ICR Details

OMB Control No: 0960-0142	ICR Reference No: 202405-0960-001
Status: Active	Previous ICR Reference No: 202210-0960-006
Agency/Subagency: SSA	Agency Tracking No:
Title: Statement of Death by Funeral Director and State Death Match
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 07/15/2024
Retrieve Notice of Action (NOA)	Date Received in OIRA: 05/09/2024
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	07/31/2027	36 Months From Approved	07/31/2024
Responses	171,320,454	0	128,021,190
Time Burden (Hours)	42,793,660	0	36,282
Cost Burden (Dollars)	473,347,121	0	257,449,861

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Abstract: The death of a beneficiary is an event that terminates the individual’s entitlement to Social Security benefits. As regulated, states must furnish death information to SSA to compare to SSA’s payment files. SSA employs two modalities for ensuring it efficiently receives accurate information regarding the deaths of SSA-insured workers and beneficiaries: (1) Form SSA–721, Statement of Death by Funeral Director; and (2) the Electronic Death Registration (EDR). SSA operates the State Death Match collections, which includes the EDR process for electronically reporting death records to SSA. The states furnish death certificate information to SSA via a manual registration process (the SSA-721), or via the EDR Registration Process. Both death match processes are automated electronic transfers between the states and SSA. This collection, via paper form SSA-721 or the EDR, allows for the funeral director or funeral home responsible for the individual’s burial or cremation to report the death to SSA. SSA uses this information for three purposes: (1) to establish proof of death for the insured worker; (2) to determine if the insured individual was receiving any pre-death benefits SSA needs to terminate; and (3) to ascertain which surviving family member is eligible for the lump-sum death payment or for other death benefits. The respondents for this information collection are funeral directors who handled death arrangements for the insured individuals, and the states’ bureaus of vital statistics.

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Authorizing Statute(s): US Code: 42 USC 402 Name of Law: Social Security Act
   US Code: 42 USC 405(r) Name of Law: Social Security Act
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	89 FR 9887	02/12/2024
30-day Notice:	Federal Register Citation:	Citation Date:
	89 FR 30428	04/23/2024
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 3

table that charts list of burden

IC Title	Form No.	Form Name
Report of Death by Funeral Director	SSA-721	Statement of Death by Funeral Director
State Death Match - Electronic Death Registration (EDR)
State Death Match - Manual - Non-EDR
State Death Match - Manual - Non-EDR Records from EDR sites
State Death Match - States Expected to Become EDR's within next 3 Year

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ICR Summary of Burden

table that charts list of burden

	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	171,320,454	128,021,190	0	-3,614,069	46,913,333	0
Annual Time Burden (Hours)	42,793,660	36,282	0	312	42,757,066	0
Annual Cost Burden (Dollars)	473,347,121	257,449,861	0	-3,180,381	219,077,641	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: When we last cleared this ICR in 2021, the burden for the SSA-721 was 36,282 hours. However, we are currently reporting a burden of 29,163 hours. This change stems from a decrease in the number of responses for the SSA-721 from 544,233 to 437,449. There is no change to the burden time per response. Although the number of responses changed, SSA did not take any actions to cause this change. These figures represent current Management Information data. When we last cleared this ICR in 2021, we reported a total of 123,549,888 responses annually. However, we are currently reporting 170,881,758 responses annually. This change stems from a minor increase in the number of respondents for EDR. Previously, we showed 5 states who expected to use EDR for submission, and now 4 of those states have registered to use EDR. We are still reporting one state who expects to use EDR within the next 3 years. In addition, we note that the states also submitted higher numbers of responses, likely due to the COVID pandemic. We expect the numbers to return to the lower figures within the next three years. While we have not seen any major programmatic changes to our EDR responses, we are making an adjustment to the cost burden to reflect current figures which has increased the cost to the respondents. Finally, we removed the Non-EDR manual process (two ICs) which does not use the SSA-721, as none of the states are using this process. The removal of these two ICs caused a burden decrease. * Note: The total hourly burden reflected in ROCIS is 42,793,660, while the burden cited in #12 of the Supporting Statement is 29,163. This discrepancy is because the ROCIS burden reflects the learning costs for both the SSA-721 and EDR (as shown in the chart for the Learning Costs in #12 above). In contrast, the chart in #12 of the Supporting Statement reflects actual burden.

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Annual Cost to Federal Government: $58,973,045

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     Yes

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     Yes

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? No

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Common Form ICR:  No

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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:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(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;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

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.

Certification Date: 05/09/2024

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