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Death Notification Referal - Eligible
Organ Procurement and Transplantation Network and Scientific Registry of Transplant Recipients Data System
OMB: 0915-0157
IC ID: 194823
OMB.report
HHS/HSA
OMB 0915-0157
ICR 201411-0915-004
IC 194823
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0915-0157 can be found here:
2023-06-27 - Revision of a currently approved collection
2022-02-17 - Revision of a currently approved collection
Documents and Forms
Document Name
Document Type
Form 1
Death Notification Referal - Eligible
Form
Death Notification Registration Instructions.pdf
Instruction
1 Death Notification Referral Eligible
Death Notification Registration Worksheet.pdf
Form
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Death Notification Referal - Eligible
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Removed
Obligation to Respond:
Mandatory
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form
1
Death Notification Referral Eligible
Death Notification Registration Worksheet.pdf
Yes
Yes
Fillable Fileable
Instruction
Death Notification Registration Instructions.pdf
Yes
No
Printable Only
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Health Care Services
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
58
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
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
0
0
-8,410
0
0
8,410
Annual IC Time Burden (Hours)
0
0
-4,205
0
0
4,205
Annual IC Cost Burden (Dollars)
0
0
0
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.