OPTN- Liver 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⚠️ Notice: This information collection may be referencing outdated material.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 16 OPTN- Liver Registration Form
Liver Transplant Recipient Registration Instructions.pdf Instruction
16 Liver Adult Transplant Recipient Registration Worksheet Liver Adult Transplant Recipient Registration Worksheet.pdf Form
16b Liver Pediatric Transplant Recipient Registration Worksh Liver Pediatric Transplant Recipient Registration Worksheet.pdf Form

Information Collection (IC) Details

IC Title:	OPTN- Liver 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	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	16	Liver Adult Transplant Recipient Registration Worksheet	Liver Adult Transplant Recipient Registration Worksheet.pdf	Yes	Yes	Fillable Fileable
Form	16b	Liver Pediatric Transplant Recipient Registration Worksheet	Liver Pediatric Transplant Recipient Registration Worksheet.pdf	Yes	Yes	Fillable Fileable
Instruction			Liver Transplant Recipient Registration Instructions.pdf	Yes	No	Printable Only

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 132	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	6,336	-1,146	7,482
Annual IC Time Burden (Hours)	4,118	-745	4,863
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

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.