View Information Collection Request (ICR) Package

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View ICR - OIRA Conclusion

OMB Control No: 0920-0215	ICR Reference No: 201903-0920-004
Status: Historical Active	Previous ICR Reference No: 201610-0920-008
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: No material or nonsubstantive change to a currently approved collection	Common Form ICR: No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 03/14/2019
	Date Received in OIRA: 03/11/2019
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	12/31/2019	12/31/2019	12/31/2019
Responses	290	0	290
Time Burden (Hours)	457	0	507
Cost Burden (Dollars)	0	0	0

ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to Agency Discretion
Annual Number of Responses	290	290	0
Annual Time Burden (Hours)	457	507	-50
Annual Cost Burden (Dollars)	0	0	0

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: Yes

Burden Reduction Due to: Miscellaneous Actions

Short Statement: Theis Non-Substantive Change Request results in a reduction in burden for the NDI - Application Form from 4.5 to 4 hours and the overall burden for the entire project from 507 hours to 457.

Annual Cost to Federal Government: $133,000

Does this IC contain surveys, censuses, or employ statistical methods? No

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. Yes

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. Yes

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? Uncollected

Agency Contact: Jeffrey Zirger 404 639-7118 wtj5@cdc.gov

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