Report of Death by Funeral Director

Statement of Death by Funeral Director and State Death Match

OMB: 0960-0142

IC ID: 37956

Information Collection (IC) Details

View Information Collection (IC)

Report of Death by Funeral Director
 
No Modified
 
Voluntary
 
20 CFR 404.715 20 CFR 404.720 20 CFR 416.912 20 CFR 404.301 20 CFR 404.310-404.311 20 CFR 404.316 20 CFR 404.330-404.341 20 CFR 404.350-404.352 20 CFR 404.371

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction SSA-721 Statement of Death by Funeral Director SSA-721 - Revised Version.pdf www.ssa.gov No   Fillable Printable

Income Security General Retirement and Disability

 

437,449 0
   
Private Sector Businesses or other for-profits, Not-for-profit institutions
 
   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 437,449 0 0 -106,784 0 544,233
Annual IC Time Burden (Hours) 72,908 0 0 36,626 0 36,282
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Current Version of the SSA-721 SSA-721 - Current Version.pdf 05/09/2024
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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