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ATTN: PRIVACY ACT STATEMENT

Authority: The National Technical Information Service (NTIS) Limited Access Death Master File Subscriber Certification Form, Form NTIS FM161 (Certification Form), is 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 the death of an individual 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.

Purpose: NTIS is collecting this information through the Certification Form to verify the certification status of those requesting access to the Limited Access Death Master File.

Routine Uses: NTIS will use this information to maintain a list of those certified to receive access to the Limited Access Death Master File. This list will be disclosed to Members of Congress per Section 203 of the Bipartisan Budget Act of 2013 (Pub. L. 113-67) (Act). Disclosure of this information is permitted under the Privacy Act of 1974 (5 U.S.C. Section 552a) to be shared among NTIS staff for work-related purposes. Disclosure of this information is also subject to all of the published routine uses as identified in the Privacy Act System of Records Notice COMMERCE/NTIS-1 NTIS Business Systems.

Disclosure: Furnishing this information is voluntary; however, failure to provide accurate information may delay or prevent the individual from receiving access to the Limited Access Death Master File.


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If you need help with your subscription order please fill out the form below or:

Phone: 1-800-363-2068 or 703-605-6060

Fax: 703-605-6880

TDD: 703-487-4639 (8:30 a.m. to 5:00 p.m., Eastern Time)

Please include the following information: name, address, telephone number, Customer Master Number, title of your subscription, and the action to be taken such as cancellation (please include the reason why) or address change.