State Death Match - Manual - Non-EDR

Statement of Death by Funeral Director and State Death Match

Documents and Forms

Document Name Document Type
Instructions and File Format for States' Use.docx Other-Instructions and File Format f
Instructions and File Format for States' Use.docx Other-Instructions and File Format f

Information Collection (IC) Details

IC Title:	State Death Match - Manual - Non-EDR	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Removed

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Instructions and File Format for State's Use			Instructions and File Format for States' Use.docx		No		Paper Only

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 5	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	-937,850	937,850
Annual IC Time Burden (Hours)	0	0
Annual IC Cost Burden (Dollars)	-825,308	825,308

Documents for IC

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.