Information Collection

B VCA Other Designated Program Application

IC 226691 under ICR 201802-0915-002 · 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⚠️ Notice: This information collection may be referencing outdated material.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 B16 a B VCA Other Designated Program Application	Form and Instruction
B16 a B16 a VCA_Other_Updated.doc N3_VCA_Other_Updated.doc	Form and Instruction
B16 b B16 b VCA_Other_NewTransplantProgram_Cover_HRSA.doc_.doc N1_VCA_Other_NewTransplantProgram_Cover_HRSA.doc_.doc	Form and Instruction
B16 c B16 c VCA_Other_PersonnelChange_Cover_HRSA.doc_.doc N2_VCA_Other_PersonnelChange_Cover_HRSA.doc_.doc	Form and Instruction

IC Title:

B VCA Other Designated Program Application

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Unchanged

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	B16 a	B16 a VCA_Other_Updated.doc	N3_VCA_Other_Updated.doc	Yes	Yes	Fillable Fileable
Form and Instruction	B16 b	B16 b VCA_Other_NewTransplantProgram_Cover_HRSA.doc_.doc	N1_VCA_Other_NewTransplantProgram_Cover_HRSA.doc_.doc	Yes	Yes	Fillable Fileable
Form and Instruction	B16 c	B16 c VCA_Other_PersonnelChange_Cover_HRSA.doc_.doc	N2_VCA_Other_PersonnelChange_Cover_HRSA.doc_.doc	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 9

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	Previously Approved
Annual Number of Responses for this IC	18	18
Annual IC Time Burden (Hours)	36	36
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.