OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

Enterprise Management Blood System

IC 211331 under ICR 201404-0720-003 · OMB 0720-0057.

Documents and Forms
Document Name
Document Type
Other-Instrument Screen Shots
Other-Blood Donation Record Output Q
Other-Blood Donation Record Output Q
Other-Blood Donation Record Output Q
Other-Compatibility Testing Record O
Other-Donor On-Line Agency Disclosur
Information Collection (IC) Details

View Information Collection (IC)

Enterprise Management Blood System
 
No New
 
Voluntary
 
21 CFR 200 Series 21 CFR 600 Series 21 CFR 800 Series

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-Instrument Screen Shots PSI_BDMS_HH_Screenshots_20131206.pdf Yes Yes Fillable Fileable
Other-Blood Donation Record Output Qs 1-49 Allogeneic UDHQ.pdf Yes Yes Fillable Fileable
Other-Blood Donation Record Output Qs 101-114 Autologous UDHQ.pdf Yes Yes Fillable Fileable
Other-Blood Donation Record Output Qs 201-206 Therapeutic UDHQ.pdf Yes Yes Fillable Fileable
Other-Compatibility Testing Record Output Compatibility Testing Output Record.pdf Yes Yes Fillable Fileable
Other-Donor On-Line Agency Disclosure Notice Donor_Disclosure Statement.pdf Yes Yes Fillable Fileable

Defense and National Security Operational Defense

 

4,600 0
   
Individuals or Households
 
   100 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 4,600 0 4,600 0 0 0
Annual IC Time Burden (Hours) 767 0 767 0 0 0
Annual IC Cost Burden (Dollars) 12,806 0 12,806 0 0 0

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.