Information Collection

Vascular Composite Allograft

IC 214131 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⚠️ Notice: This information collection may be referencing outdated material.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 50 Vascular Composite Allograft	Form and Instruction
50a VCA COD lookup.xlsx	Instruction
50 Vascular Composit Allograft Candidate Registration 50 VCA TCR Instructions.docx	Form and Instruction
51 Vascular Composit Allograft Recipient Registration 51 VCA TRR Instructions.docx	Form and Instruction
52 Vascular Composit Allograft Recipient Follow Up 52 VCA TRF Instructions.docx	Form and Instruction

IC Title:

Vascular Composite Allograft

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

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	50	Vascular Composit Allograft Candidate Registration	50 VCA TCR Instructions.docx	Yes	Yes	Fillable Fileable
Instruction			50a VCA COD lookup.xlsx	Yes	Yes	Fillable Fileable
Form and Instruction	51	Vascular Composit Allograft Recipient Registration	51 VCA TRR Instructions.docx	Yes	Yes	Fillable Fileable
Form and Instruction	52	Vascular Composit Allograft Recipient Follow Up	52 VCA TRF Instructions.docx	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 16

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
Annual Number of Responses for this IC	43	43
Annual IC Time Burden (Hours)	39	39
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.