Information Collection

OPTN- Kidney/Pancreas Registration

IC 181743 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⚠️ Notice: This information collection may be referencing outdated material.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
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

IC Title:

OPTN- Kidney/Pancreas Registration

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Removed

Obligation to Respond: Mandatory

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
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
Form	19b	Kidney-Pancreas Pediatric Tranplant Recipient Registration Worksheet	Kidney-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 %

table that charts list of burden
	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	-864	864
Annual IC Time Burden (Hours)	-778	778
Annual IC Cost Burden (Dollars)	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.