Information Collection

OPTN- Kidney/Pancreas Registration

IC 181743 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⚠️ Notice: This information collection may be referencing outdated material.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 19 OPTN- Kidney/Pancreas Registration	Form
19 Kidney/Pancreas Registration TRR Kidney-Pancreas Adult Wksheet.pdf	Form
19b Kidney/Pancreas Pediatric Registration TRR Kidney-Pancreas Pediatric Wksheet.pdf	Form
Transplant Recipient Follow-up - Kidney-Pancreas.doc Transplant Recipient Follow-up - Kidney-Pancreas	IC Document

IC Title:

OPTN- Kidney/Pancreas Registration

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	19	Kidney/Pancreas Registration	TRR Kidney-Pancreas Adult Wksheet.pdf		Yes	Yes	Fillable Fileable
Form	19b	Kidney/Pancreas Pediatric Registration	TRR Kidney-Pancreas 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: 143

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	1,001	-21	1,022
Annual IC Time Burden (Hours)	901	359	542
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Transplant Recipient Follow-up - Kidney-Pancreas	Transplant Recipient Follow-up - Kidney-Pancreas.doc	09/14/2010

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