OPTN- Heart 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⚠️ Notice: This information collection may be referencing outdated material.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 7 OPTN- Heart Candidate Registration Form
7 Heart Candidate Registration TCR Heart Adult Wksheet.pdf Form
7b Heart Candidate Pediatric Registration TCR Heart Pediatric Wksheet.pdf Form
TCR Heart Help.pdf Heart Candidate Registration Instructions IC Document

Information Collection (IC) Details

IC Title:	OPTN- Heart Candidate Registration	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	7	Heart Candidate Registration	TCR Heart Adult Wksheet.pdf		Yes	Yes	Fillable Fileable
Form	7b	Heart Candidate Pediatric Registration	TCR Heart Pediatric 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: 127	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	4,445	1,340	3,105
Annual IC Time Burden (Hours)	2,223	1,354	869
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded
Heart Candidate Registration Instructions	TCR Heart Help.pdf	07/17/2007

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