[NCHS] National Vital Statistics Report Forms

Forms and Documents

Document Name	Status
Form 0920-0213 Annual Vital Statistics Occurance Report Form	Modified
SSB National Vital Statistics Reporting Form.docx Supporting Statement B	2025-11-20
SSA National Vital Statistics Reporting Form.docx Supporting Statement A	2025-11-20
Attachment D - IRB Documentation.pdf Supplementary Document	2025-10-02
Attachment B1 - 60-day FRN 0920-0213.pdf Supplementary Document	2025-10-02
Att D IRB Letter_3.9.2022.pdf Supplementary Document	2022-05-13
Att B Published 60-Day FRN NVSR.pdf Supplementary Document	2022-05-13
Att A LegisAuth.pdf Supplementary Document	2022-05-13

IC Document Collections

IC ID	Document Title	Status
6670	Annual Vital Statistics Occurance Report Form	Modified

ICR Details

OMB Control No: 0920-0213	ICR Reference No: 202509-0920-012
Status: Received in OIRA	Previous ICR Reference No: 202203-0920-008
Agency/Subagency: HHS/CDC	Agency Tracking No: 0920-0213
Title: [NCHS] National Vital Statistics Report Forms
Type of Information Collection: Reinstatement without change of a previously approved collection	Common Form ICR:  No
Type of Review Request: Regular	Date Submitted to OIRA: 11/20/2025

	Requested	Previously Approved
Expiration Date	36 Months From Approved
Responses	91	0
Time Burden (Hours)	46	0
Cost Burden (Dollars)	300	0

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Abstract: The Annual Vital Statistics Occurrence Report is used by State and/or county vital registration offices to report to the Federal government annual counts of marriages and divorces/annulments in support of the National Vital Statistics System. The data is routinely available in each reporting office as a by-product of ongoing activities. Final counts of marriages and divorces are requested from all 50 States, District of Columbia, New York City, American Samoa, Guam, Commonwealth of the Northern Mariana Islands, Puerto Rico, Virgin Islands, as well as the counties of New Mexico for all months of a given year. NCHS has submitted a Reinstatement ICR for an additional three-year approval. There is no change to the previously approved burden hours.

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Authorizing Statute(s): US Code: 42 USC 242k Name of Law: Public Health Service 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:
	90 FR 25294	06/16/2025
30-day Notice:	Federal Register Citation:	Citation Date:
	90 FR 47761	10/02/2025
Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
Annual Vital Statistics Occurance Report	0920-0213, 0920-0213	Annual Vital Statistics Occurance Report ,   ANNUAL VITAL STATISTICS OCCURRENCE REPORT_2025

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ICR Summary of Burden

	Total Request	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	91	0	0	0	0	91
Annual Time Burden (Hours)	46	0	0	0	0	46
Annual Cost Burden (Dollars)	300	0	0	0	0	300

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

Burden Increase Due to:

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

Burden Reduction Due to:

Short Statement:

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Annual Cost to Federal Government: $100,000

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

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.     No

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.     No

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: 11/20/2025

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