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

OMB 0692-0013

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.

The latest form for NTIS Limited Access Death Master File (LADMF) Certification Form (Derived from the Social Security Administration's Death Master File) expires 2023-03-31 and can be found here.

Latest Forms, Documents, and Supporting Material

Document Name
Form NTIS FM161 NTIS Limited Access Death Master File Subscriber Certification Form Form
0692-0013-NTIS-LADMF-CertificationForm-SupportingStatement_Final A.docx Supporting Statement A
NTIS Limited Access Death Master File Subscriber Certification Form Form

202303-0692-002 Approved without change	Extension without change of a currently approved collection	2023-03-16
202001-0692-001 Approved with change	Revision of a currently approved collection	2020-01-30
201908-0692-002 Approved without change	No material or nonsubstantive change to a currently approved collection	2019-08-27
201908-0692-001 Improperly submitted and continue	No material or nonsubstantive change to a currently approved collection	2019-08-05
201610-0692-001 Approved without change	Revision of a currently approved collection	2016-12-02
201411-0692-001 Approved without change	Reinstatement without change of a previously approved collection	2014-11-14
201403-0692-001 Approved with change	New collection (Request for a new OMB Control Number)	2014-03-13