Statement of Death by Funeral Director and State Death Match

ICR 202405-0960-001

OMB: 0960-0142

Federal Form Document

Forms and Documents

Document Name	Status
Form SSA-721 Report of Death by Funeral Director Form and Instruction	Modified
Addendum - 0142.docx Supplementary Document	2024-05-09
Supporting Statement - 0142.docx Supporting Statement A	2024-05-09

IC Document Collections

IC ID	Document Title	Status
37956	Report of Death by Funeral Director Form and Instruction	Modified
256495	State Death Match - States Expected to Become EDR's within next 3 Year Other-Death Screen Images	Modified
256494	State Death Match - Electronic Death Registration (EDR) Other-Death Screen Images	Modified
256493	State Death Match - Manual - Non-EDR Other-Instructions and File Format for State's Use	Removed
256492	State Death Match - Manual - Non-EDR Records from EDR sites Other-ile Format for State's Use	Removed