OPTN- Kidney/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⚠️ Notice: This information collection may be referencing outdated material.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 19b OPTN- Kidney/Pancreas Registration Form
Kidney-Pancreas Transplant Recipient Registration Instructions.pdf Instruction
19 Kidney-Pancreas Adult Transplant Recipient Registration Kidney-Pancreas Adult Transplant Recipient Registration.pdf Form
19b Kidney-Pancreas Pediatric Tranplant Recipient Registrati Kidney-Pancreas Pediatric Transplant Recipient Registration Worksheet.pdf Form

Information Collection (IC) Details

IC Title:	OPTN- Kidney/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	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	19b	Kidney-Pancreas Pediatric Tranplant Recipient Registration Worksheet	Kidney-Pancreas Pediatric Transplant Recipient Registration Worksheet.pdf	Yes	Yes	Fillable Fileable
Instruction			Kidney-Pancreas Transplant Recipient Registration Instructions.pdf	Yes	No	Printable Only
Form	19	Kidney-Pancreas Adult Transplant Recipient Registration	Kidney-Pancreas Adult Transplant Recipient Registration.pdf	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 144	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	864	-137	1,001
Annual IC Time Burden (Hours)	778	-123	901
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.