View Information Collection Request (ICR) Package

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View ICR - OIRA Conclusion

OMB Control No: 0920-0215	ICR Reference No: 201610-0920-008
Status: Historical Active	Previous ICR Reference No: 201309-0920-006
Agency/Subagency: HHS/CDC	Agency Tracking No: 20486
Title: Application Form and Related Forms for the Operation of the National Death Index
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: 12/09/2016
	Date Received in OIRA: 10/14/2016
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	12/31/2019	36 Months From Approved	12/31/2016
Responses	290	0	240
Time Burden (Hours)	507	0	182
Cost Burden (Dollars)	0	0	0

ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to Agency Discretion	Change Due to Adjustment in Estimate
Annual Number of Responses	290	240	0	50
Annual Time Burden (Hours)	507	182	100	225
Annual Cost Burden (Dollars)	0	0	0	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: There are minor changes to the content of all 3 forms. In addition, for the NDI Application Form, there is an increase in the estimated number of responses, and the estimated burden per response will increase from 2.5 hours to 4.5 hours. The revised estimate for burden per response reflects changes to content and the additional time needed to complete the application for submitters who represent multi-site entities.

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