OPTN- Kidney Candidate Registration

Organ Procurement and Transplantation Network and Scientific Registry of Transplant Recipients Data System

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0915-0157 can be found here:

Documents and Forms

Document Name Document Type
Form 12b OPTN- Kidney Candidate Registration Form
12b Kidney Candidate Pediatric Registration TCR Kidney Pediatric Wksheet.pdf Form
12 Kidney Candidate Registration TCR Kidney Adult Wksheet.pdf Form
TCR Kidney Help.pdf Kidney Candidate Registration Instructions IC Document
TCR All Organs Doc.pdf Kidney Candidate Registration Changes IC Document

Information Collection (IC) Details

IC Title:	OPTN- Kidney Candidate Registration	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	12b	Kidney Candidate Pediatric Registration	TCR Kidney Pediatric Wksheet.pdf		Yes	Yes	Fillable Fileable
Form	12	Kidney Candidate Registration	TCR Kidney Adult Wksheet.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 250	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Change Due to Adjustment in Agency Estimate
Annual Number of Responses for this IC	33,250	33,250
Annual IC Time Burden (Hours)	9,310	9,310
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Kidney Candidate Registration Instructions	TCR Kidney Help.pdf	07/18/2007
Kidney Candidate Registration Changes	TCR All Organs Doc.pdf	07/18/2007

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.