Information Collection

OPTN Non-Institutional Application

IC 183029 under ICR 201102-0915-005 · OMB 0915-0184.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0915-0184 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 2 OPTN Non-Institutional Application	Form and Instruction
2 G_medical_scientific_app G_Medical_Scientific_Org_appl_2010_Nov.doc www.optn.org	Form and Instruction
1 Business_Member_app I_Business_member_appl_2010_Nov.doc www.optn.org	Form and Instruction
3 Public_organ_app H_Public_Org_appl_2010_Nov.doc	Form and Instruction
4 Individual_member_app J_Individual_member_appl_2010_Nov.doc www.optn.org	Form and Instruction

IC Title:

OPTN Non-Institutional Application

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation: 42 CFR 121

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 and Instruction	2	G_medical_scientific_app	G_Medical_Scientific_Org_appl_2010_Nov.doc	www.optn.org	Yes	No	Printable Only
Form and Instruction	1	Business_Member_app	I_Business_member_appl_2010_Nov.doc	www.optn.org	Yes	No	Printable Only
Form and Instruction	3	Public_organ_app	H_Public_Org_appl_2010_Nov.doc		Yes	No	Printable Only
Form and Instruction	4	Individual_member_app	J_Individual_member_appl_2010_Nov.doc	www.optn.org	Yes	No	Printable Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 20

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: 0 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	20	20
Annual IC Time Burden (Hours)	200	200
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

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