Information Collection

OPTN- Deceased Donor Registration Worksheet

IC 6389 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⚠️ Notice: This information collection may be referencing outdated material.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 1b OPTN- Deceased Donor Registration Worksheet	Form
1b Imminent-Eligible Death Doc Imminent-Eligible Death Wksheet.pdf	Form
1 Deceased Donor Registration FINALDeceased Donor Registration Wksheet.pdf	Form
Deceased Donor Registration.doc Deceased Donor Registration	IC Document

IC Title:

OPTN- Deceased Donor Registration Worksheet

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	1b	Imminent-Eligible Death Doc	Imminent-Eligible Death Wksheet.pdf		Yes	Yes	Fillable Fileable
Form	1	Deceased Donor Registration	FINALDeceased Donor Registration 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: 58

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	12,528	58	12,470
Annual IC Time Burden (Hours)	9,396	4,159	5,237
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Deceased Donor Registration	Deceased Donor Registration.doc	09/13/2010

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