Information Collection

Liver Recipient Explant Pathology Form

IC 214130 under ICR 201704-0915-007 · 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⚠️ Notice: This information collection may be referencing outdated material.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

Document Name Document Type
Liver Recipient Explant Pathology_Instructions.docx Instruction
28 Liver Recipient Explant Pathology_Form.xlsx Liver Recipient Explant Pathology_Form.xlsx Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Liver Recipient Explant Pathology Form	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

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
Instruction			Liver Recipient Explant Pathology_Instructions.docx		Yes	Yes	Fillable Fileable
Form	28	Liver Recipient Explant Pathology_Form.xlsx	Liver Recipient Explant Pathology_Form.xlsx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 140	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 Agency Discretion	Previously Approved
Annual Number of Responses for this IC	1,812	153	1,659
Annual IC Time Burden (Hours)	1,087	92	995
Annual IC Cost Burden (Dollars)	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.