OPTN- Pancreas 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⚠️ Notice: This information collection may be referencing outdated material.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 22b OPTN- Pancreas Registration Form
22b Pancreas Pediatric Registration TRR Pancreas Pediatric Wksheet.pdf Form
22 Pancreas Registration TRR Pancreas Adult Wksheet.pdf Form
Transplant Recipient Registration - Pancreas.doc Transplant Recipient Registration - Pancreas IC Document

Information Collection (IC) Details

IC Title:	OPTN- Pancreas 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	22b	Pancreas Pediatric Registration	TRR Pancreas Pediatric Wksheet.pdf		Yes	Yes	Fillable Fileable
Form	22	Pancreas Registration	TRR Pancreas Adult 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	429	-9	438
Annual IC Time Burden (Hours)	322	129	193
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded
Transplant Recipient Registration - Pancreas	Transplant Recipient Registration - Pancreas.doc	09/14/2010

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