Information Collection

Baseline Pre-TED (Transplant Essential Data)

IC 180280 under ICR 202003-0915-002 · OMB 0915-0310.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0915-0310 can be found here:

Documents and Forms

Document Name Document Type
Form 1 Baseline Pre-TED (Transplant Essential Data) Form
1 Baseline Pre-TED (Transplant Essential Data) FormBaselinePreTED.pdf Form
03.11.2020 Pre-TED Form 2400 Proposed Changes.docx Proposed Changes Pre-TED Form IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Baseline Pre-TED (Transplant Essential Data)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	1	Baseline Pre-TED (Transplant Essential Data)	FormBaselinePreTED.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 200	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Previously Approved
Annual Number of Responses for this IC	9,600	9,600
Annual IC Time Burden (Hours)	6,560	6,560
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Proposed Changes Pre-TED Form	03.11.2020 Pre-TED Form 2400 Proposed Changes.docx	03/16/2020

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.