Information Collection

OPTN Personnel Change Application

IC 183028 under ICR 201705-0915-002 · OMB 0915-0184.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0915-0184 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form E OPTN Personnel Change Application	Form and Instruction
E Personnel Change Application (Transplant Program) E_PersonnelChange_Cover.doc	Form and Instruction
F Change in Key Personnel Application - Histocompatibility F_HistoLab_DirectorChange.doc	Form and Instruction
G Application for Approval for Change in Key Personnel - O G_OPO_DirectorChange.doc	Form and Instruction

IC Title:

OPTN Personnel Change Application

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Removed

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 42 CFR 121

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	E	Personnel Change Application (Transplant Program)	E_PersonnelChange_Cover.doc	Yes	Yes	Fillable Fileable
Form and Instruction	F	Change in Key Personnel Application - Histocompatibility Laboratory	F_HistoLab_DirectorChange.doc	Yes	Yes	Fillable Printable
Form and Instruction	G	Application for Approval for Change in Key Personnel - OPO	G_OPO_DirectorChange.doc	Yes	Yes	Fillable Printable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 395

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: 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	-772	772
Annual IC Time Burden (Hours)	-3,042	3,042
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.