OPTN- Kidney/Pancreas Follow-up

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⚠️ Notice: This information collection may be referencing outdated material.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 20b OPTN- Kidney/Pancreas Follow-up Form
20b Kidney/Pancreas Pediatric Follow-up TRF Kidney-Pancreas Pediatric Wksheet.pdf Form
20 Kidney/Pancreas Follow-up TRF Kidney-Pancreas Adult Wksheet.pdf Form
20c Post 5-Year Kidney/Pancreas Follow-up TRF Post 5-Year All Organs Adult Wksheet.pdf Form
20d Post 5-Year Kidney/Pancreas Pediatric Follow-up TRF Post 5-Year All Organs Pediatric Wksheet.pdf Form
Transplant Recipient Follow-up - Kidney-Pancreas.doc Transplant Recipient Follow-up - Kidney-Pancreas IC Document
Transplant Recipient Follow-up - Kidney - Post 5-Year.doc Transplant Recipient Follow-up - Kidney - Post 5-Year IC Document

Information Collection (IC) Details

IC Title:	OPTN- Kidney/Pancreas Follow-up	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	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	20b	Kidney/Pancreas Pediatric Follow-up	TRF Kidney-Pancreas Pediatric Wksheet.pdf	Yes	Yes	Fillable Fileable
Form	20	Kidney/Pancreas Follow-up	TRF Kidney-Pancreas Adult Wksheet.pdf	Yes	Yes	Fillable Fileable
Form	20c	Post 5-Year Kidney/Pancreas Follow-up	TRF Post 5-Year All Organs Adult Wksheet.pdf	Yes	Yes	Fillable Fileable
Form	20d	Post 5-Year Kidney/Pancreas Pediatric Follow-up	TRF Post 5-Year All Organs 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 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	12,155	2,665	9,490
Annual IC Time Burden (Hours)	10,332	5,561	4,771
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded
Transplant Recipient Follow-up - Kidney-Pancreas	Transplant Recipient Follow-up - Kidney-Pancreas.doc	09/14/2010
Transplant Recipient Follow-up - Kidney - Post 5-Year	Transplant Recipient Follow-up - Kidney - Post 5-Year.doc	09/14/2010

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