OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

NTIS Limited Access Death Master Files (LADMF) Systems Safeguards Attestation Forms

ICR 201702-0692-001 · OMB 0692-0016 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
Form NTIS FM 100B NTIS Limited Access Death Master File (LADMF) State or Local Government Auditor General (AG) or Inspector General (IG) Systems Safeguards Attestation Form Systems Safeguards Attestation Form Form and Instruction New Available
Form NTIS FM 100A NTIS Limited Access Death Master File Accredited Conformity Assessment Body Systems Safeguards Attestation Form Form and Instruction New Available
Form NTIS FM100B NTIS Limited Access Death Master File (LADMF) State or Local Government Auditor General (AG) or Inspector General (IG) Systems Safeguards Attestation Forment Body Systems Safeguards Attestation Form Form and Instruction Removed Available
Form NTIS FM100A NTIS Limited Access Death Master File Accredited Conformity Assessment Body Systems Safeguards Attestation Form Form and Instruction Removed Available
0692-0015-NTIS-Notes OMB NTIS CDIA 100417.docx Supplementary Document Uploaded 2017-10-06 Available
NTIS DMF PIA SAOP Approved 031517.pdf Supplementary Document Uploaded 2017-07-14 Available
5-24-2017_CDIA Comments to OMB_FM100A.pdf Public Comments Uploaded 2017-05-24 Repair queued
0692-XXXX-Emergency-NTIS-LADMF-AttestationForms-DRAFT-NTIS-1_SORN_v0-6.docx Supplementary Document Uploaded 2017-01-04 Repair queued
0692-XXXX-Emergency-NTIS-LADMF-AttestationForms-DRAFT-DMF-Cert-PIA_v0-4.docx Supplementary Document Uploaded 2017-01-04 Available
0692-0016-NTIS-LADMF-SystemsSafeguardsAttestationForms-SuportingStatemen_revised10-4-17_.docx Supporting Statement A Uploaded 2017-10-06 Available
IC Document Collections
IC IDCollectionTypeStatusForm
225787 NTIS Limited Access Death Master File (LADMF) Accredited Conformity Assessment Body Systems Safeguards Attestation Form Form and Instruction NewNTIS Limited Access Death Master File (LADMF) State or Local Government Auditor General (AG) or Inspector General (IG) Systems Safeguards Attestation Form Systems Safeguards Attestation Form
225787 NTIS Limited Access Death Master File (LADMF) Accredited Conformity Assessment Body Systems Safeguards Attestation Form Form and Instruction NewNTIS Limited Access Death Master File Accredited Conformity Assessment Body Systems Safeguards Attestation Form
224604 NTIS Limited Access Death Master File (LADMF) State or Local Government Auditor General (AG) or Inspector General (IG) Systems Attestation Formsttestation Form Form and Instruction RemovedNTIS Limited Access Death Master File (LADMF) State or Local Government Auditor General (AG) or Inspector General (IG) Systems Safeguards Attestation Forment Body Systems Safeguards Attestation Form
224602 NTIS Limited Access Death Master File (LADMF) Accredited Conformity Assessment Body Systems Safeguards Attestation Form Form and Instruction RemovedNTIS Limited Access Death Master File Accredited Conformity Assessment Body Systems Safeguards Attestation Form
ICR Details
0692-0016 201702-0692-001
Historical Active 201611-0692-002
DOC/NTIS DY
NTIS Limited Access Death Master Files (LADMF) Systems Safeguards Attestation Forms
Revision of a currently approved collection   No
Regular
Approved with change 10/18/2017
Retrieve Notice of Action (NOA) 04/20/2017
This collection is approved based on the revised materials provided by the Department.
  Inventory as of this Action Requested Previously Approved
10/31/2020 36 Months From Approved 10/31/2017
560 0 560
1,680 0 1,680
0 0 0
The National Technical Information Service (NTIS) Limited Access Death Master File Accredited Conformity Assessment Body Systems Safeguards Attestation Form (ACAB Systems Safeguards Attestation Form) and the Limited Access Death Master File State or Local Auditor General or Inspector General Systems Safeguard Attestation Form (AG or IG Systems Safeguards Attestation Form) are used to collect information related to the implementation of Section 203 of the Bipartisan Budget Act of 2013 (Pub. L. 113-67) (Act). Section 203 of the Act prohibits disclosure of Limited Access Death Master File (Limited Access DMF) information during the three-calendar-year period following death unless the person requesting the information has been certified under a program established by the Secretary of Commerce. The Act directs the Secretary of Commerce to establish a certification program for such access to the Limited Access DMF. The Secretary of Commerce has delegated the authority to carry out the DMF certification program to the Director, NTIS.
PL: Pub.L. 113 - 67 203 Name of Law: Bipartisan Budget Act of 2013
  
None
Not associated with rulemaking
  82 FR 9991 02/09/2017
82 FR 18609 04/20/2017
No
  Total Approved 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 560 560 0 0 0 0
Annual Time Burden (Hours) 1,680 1,680 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
Miscellaneous Actions
Yes
Miscellaneous Actions
Forms now display the OMB Control # and current expiration date.
$294,000
No
    No
    No
No
No
No
Uncollected
John Hounsell 703 605-6184 [email protected]
  No
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:
 
 
 
 
 
 
 
    (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;
 
 
 
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.
04/20/2017