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⚠️ Notice: This information collection may be referencing outdated material.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
Pancreas Transplant Recipient Registration Instructions.pdf Instruction
22 Pancreas Adult Transplant Recipient Registration Workshe Pancreas Adult Transplant Recipient Registration Worksheet.pdf Form
22b Pancreas Pediatric Transplant Recipient Registration Wor Pancreas Pediatric Transplant Recipient Registration Worksheet.pdf Form

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	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Instruction			Pancreas Transplant Recipient Registration Instructions.pdf	Yes	No	Printable Only
Form	22	Pancreas Adult Transplant Recipient Registration Worksheet	Pancreas Adult Transplant Recipient Registration Worksheet.pdf	Yes	Yes	Fillable Fileable
Form	22b	Pancreas Pediatric Transplant Recipient Registration Worksheet	Pancreas Pediatric Transplant Recipient Registration Worksheet.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	288	-141	429
Annual IC Time Burden (Hours)	216	-106	322
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.