Information Collection

OPTN- Liver Follow-up

IC 181741 under ICR 201411-0915-004 · OMB 0915-0157.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0915-0157 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 26 OPTN- Liver Follow-up	Form and Instruction
26 Liver Recipient Follow up (6 months - 5 years) 26 Liver Transplant Recipient Follow_Instructions.docx	Form and Instruction
27 Liver Recipient Follow up (Post 5 years) 27 Liver Post 5 Year Transplant Recipient Follow_Instructions.docx	Form and Instruction

IC Title:

OPTN- Liver Follow-up

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation:

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	26	Liver Recipient Follow up (6 months - 5 years)	26 Liver Transplant Recipient Follow_Instructions.docx		Yes	Yes	Fillable Fileable
Form and Instruction	27	Liver Recipient Follow up (Post 5 years)	27 Liver Post 5 Year Transplant Recipient Follow_Instructions.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 136

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 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	65,824	5,236	60,588
Annual IC Time Burden (Hours)	48,511	18,217	30,294
Annual IC Cost Burden (Dollars)	0	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.