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OPTN- Kidney/Pancreas Follow-up
Organ Procurement and Transplantation Network and Scientific Registry of Transplant Recipients Data System
OMB: 0915-0157
IC ID: 181744
OMB.report
HHS/HSA
OMB 0915-0157
ICR 200708-0915-004
IC 181744
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0915-0157 can be found here:
2023-06-27 - Revision of a currently approved collection
2022-02-17 - Revision of a currently approved collection
Documents and Forms
Document Name
Document Type
Form 20b
OPTN- Kidney/Pancreas Follow-up
Form
20b Kidney/Pancreas Pediatric Follow-up
TRF Kidney-Pancreas Pediatric Wksheet.pdf
Form
20 Kidney/Pancreas Follow-up
TRF Kidney-Pancreas Adult Wksheet.pdf
Form
20c Post 5-Year Kidney/Pancreas Follow-up
TRF Post 5-Year All Organs Adult Wksheet.pdf
Form
20d Post 5-Year Kidney/Pancreas Pediatric Follow-up
TRF Post 5-Year All Organs Pediatric Wksheet.pdf
Form
TRF Kidney-Pancreas Help.pdf
Kidney/Pancreas Follow-up Instructions
IC Document
TRF All Organs Doc.pdf
Kidney/Pancreas Follow-up Changes
IC Document
TRF Post 5-Year All Organs Doc.pdf
Post 5-Year Kidney/Pancreas Follow-up Changes
IC Document
TRF Post 5-Year Kidney-Pancreas Help.pdf
Post 5-Year Kidney/Pancreas Instructions
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
OPTN- Kidney/Pancreas Follow-up
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
20b
Kidney/Pancreas Pediatric Follow-up
TRF Kidney-Pancreas Pediatric Wksheet.pdf
Yes
Yes
Fillable Fileable
Form
20
Kidney/Pancreas Follow-up
TRF Kidney-Pancreas Adult Wksheet.pdf
Yes
Yes
Fillable Fileable
Form
20c
Post 5-Year Kidney/Pancreas Follow-up
TRF Post 5-Year All Organs Adult Wksheet.pdf
Yes
Yes
Fillable Fileable
Form
20d
Post 5-Year Kidney/Pancreas Pediatric Follow-up
TRF Post 5-Year All Organs Pediatric Wksheet.pdf
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Health Care Services
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
146
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
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
9,490
0
0
9,490
0
0
Annual IC Time Burden (Hours)
4,771
0
0
4,771
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Kidney/Pancreas Follow-up Instructions
TRF Kidney-Pancreas Help.pdf
07/19/2007
Kidney/Pancreas Follow-up Changes
TRF All Organs Doc.pdf
07/19/2007
Post 5-Year Kidney/Pancreas Follow-up Changes
TRF Post 5-Year All Organs Doc.pdf
07/23/2007
Post 5-Year Kidney/Pancreas Instructions
TRF Post 5-Year Kidney-Pancreas Help.pdf
07/23/2007
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.