Information Collection

Kidney/Pancreas

IC 181742 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⚠️ Notice: This information collection may be referencing outdated material.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 45 Kidney/Pancreas	Form and Instruction
45 Kidney/Pancreas Candidate Registration 45 KidneyPancreas Transplant Candidate Registration_Instructions.docx	Form and Instruction
46 Kidney/Pancreas Recipient Registration 46 KidneyPancreas Transplant Recipient Registration_Instructions.docx	Form and Instruction
47 Kidney/Pancreas Recipient Follow up (6 months - 5 years) 47 KidneyPancreas Transplant Recipient Follow Up_Instructions.docx	Form and Instruction
48 Kidney/Pancreas Recipient Follow up (Post 5 years) 48 KidneyPancreas Post 5 YR Transplant Recipient Follow Up_Instructions.docx	Form and Instruction

IC Title:

Kidney/Pancreas

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	45	Kidney/Pancreas Candidate Registration	45 KidneyPancreas Transplant Candidate Registration_Instructions.docx	Yes	Yes	Fillable Fileable
Form and Instruction	46	Kidney/Pancreas Recipient Registration	46 KidneyPancreas Transplant Recipient Registration_Instructions.docx	Yes	Yes	Fillable Fileable
Form and Instruction	47	Kidney/Pancreas Recipient Follow up (6 months - 5 years)	47 KidneyPancreas Transplant Recipient Follow Up_Instructions.docx	Yes	Yes	Fillable Fileable
Form and Instruction	48	Kidney/Pancreas Recipient Follow up (Post 5 years)	48 KidneyPancreas Post 5 YR Transplant Recipient Follow Up_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: 135

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	25,029	23,445	1,584
Annual IC Time Burden (Hours)	21,188	20,396	792
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.