View Information Collection Request (ICR) Package

Please note that the OMB number and expiration date may not have been determined when this Information Collection Request and associated Information Collection forms were submitted to OMB. The approved OMB number and expiration date may be found by clicking on the Notice of Action link below.

View ICR - OIRA Conclusion

OMB Control No: 0920-0215	ICR Reference No: 202301-0920-012
Status: Active	Previous ICR Reference No: 201912-0920-014
Agency/Subagency: HHS/CDC	Agency Tracking No: 0920-0215
Title: [NCHS] 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: 05/04/2023
	Date Received in OIRA: 02/08/2023
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	05/31/2026	36 Months From Approved	05/31/2023
Responses	2,332	0	1,730
Time Burden (Hours)	1,699	0	787
Cost Burden (Dollars)	0	0	32,460

ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to Agency Discretion
Annual Number of Responses	2,332	1,730	602
Annual Time Burden (Hours)	1,699	787	912
Annual Cost Burden (Dollars)	0	32,460	-32,460

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: Yes

Burden Reduction Due to: Miscellaneous Actions

Short Statement: Currently, there are 787 total burden hours in the OMB inventory. We are requesting 1,699; a program change of an increase of 912 hours, due primarily to the increases in the number of applications and transmittal forms. The NDI program receives approximately 220 new applications each year from 120 in the last submission.

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. 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

Agency Contact: Kevin Joyce 404 639-1944 kdj7@cdc.gov

Something went wrong when downloading this file. If you have any questions, please send an email to risc@gsa.gov.