Information Collection

OPTN- Deceased Donor Registration Worksheet

IC 6389 under ICR 200708-0915-004 · OMB 0915-0157.

⚠️ Notice: This information collection may be referencing outdated material.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

Documents and Forms

Documents and forms in this information collection
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

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:

table that charts list of 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 %

table that charts list of burden
	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

table that charts IC Documents
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.