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Heart, Lung, Heart/Lung Follow Up (Post 5 year)
Organ Procurement and Transplantation Network and Scientific Registry of Transplant Recipients Data System
OMB: 0915-0157
IC ID: 214128
OMB.report
HHS/HSA
OMB 0915-0157
ICR 201411-0915-004
IC 214128
( )
⚠️ Notice: This information collection may be referencing outdated material.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 22
Heart, Lung, Heart/Lung Follow Up (Post 5 year)
Form and Instruction
22 Heart, Lung, Heart/Lung Follow Up (Post 5 year)
22 Thoracic Post 5 Year Transplant Recipient Follow HR_LU_HL_Instructions.docx
Form and Instruction
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Heart, Lung, Heart/Lung Follow Up (Post 5 year)
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
New
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 and Instruction
22
Heart, Lung, Heart/Lung Follow Up (Post 5 year)
22 Thoracic Post 5 Year Transplant Recipient Follow HR_LU_HL_Instructions.docx
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Public Health Monitoring
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
259
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
19,485
0
19,485
0
0
0
Annual IC Time Burden (Hours)
11,691
0
11,691
0
0
0
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.