OPTN- Deceased Donor Registration Worksheet

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⚠️ Notice: This information collection may be referencing outdated material.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 1b OPTN- Deceased Donor Registration Worksheet Form
1b Imminent-Eligible Death Doc Imminent-Eligible Death Wksheet.pdf Form
1 Deceased Donor Registration FINALDeceased Donor Registration Wksheet.pdf Form
FINALDeceased Donor Registration Help.pdf Deceased Donor Instructions IC Document
FINALDeceased Donor Registration Doc.pdf Deceased Donor Changes IC Document
Imminent-Eligible Death Doc.pdf Imminent-Eligible Death Changes IC Document
Imminent-Eligible Death Help.pdf Imminent-Eligible Death Instructions IC Document

Information Collection (IC) Details

IC Title:	OPTN- Deceased Donor Registration Worksheet	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

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	1b	Imminent-Eligible Death Doc	Imminent-Eligible Death Wksheet.pdf		Yes	Yes	Fillable Fileable
Form	1	Deceased Donor Registration	FINALDeceased Donor Registration 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: 58	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	Previously Approved
Annual Number of Responses for this IC	12,470	-547,292	559,762
Annual IC Time Burden (Hours)	5,237	-78,820	84,057
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded
Deceased Donor Instructions	FINALDeceased Donor Registration Help.pdf	07/24/2007
Deceased Donor Changes	FINALDeceased Donor Registration Doc.pdf	07/24/2007
Imminent-Eligible Death Changes	Imminent-Eligible Death Doc.pdf	07/26/2007
Imminent-Eligible Death Instructions	Imminent-Eligible Death Help.pdf	07/26/2007

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