Information Collection

OPTN- Living Donor Follow-up

IC 181728 under ICR 201010-0915-001 · 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⚠️ Notice: This information collection may be referencing outdated material.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 4 OPTN- Living Donor Follow-up	Form
4 Living Donor Follow-up Living Donor Fol Wksheet.pdf	Form
Living Donor Fol Help.pdf Living Donor Follow-up Instructions	IC Document
Living Donor Follow-up.doc Living Donor Follow-up	IC Document

IC Title:

OPTN- Living Donor Follow-up

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	4	Living Donor Follow-up	Living Donor Fol 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: 308

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	15,400	2,602	12,798
Annual IC Time Burden (Hours)	7,700	3,477	4,223
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Living Donor Follow-up Instructions	Living Donor Fol Help.pdf	07/17/2007
Living Donor Follow-up	Living Donor Follow-up.doc	09/14/2010

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