Information Collection

Heart Transplant Candidate Registration (TCR)

IC 181731 under ICR 202006-0915-008 · 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⚠️ Notice: This information collection may be referencing outdated material.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
Heart Transplant Candidate Registration_Instructions.docx	Instruction
6 Heart Transplant Candidate Registration_Form.xlsx Heart Transplant Candidate Registration_Form.xlsx	Form

IC Title:

Heart Transplant Candidate Registration (TCR)

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Instruction			Heart Transplant Candidate Registration_Instructions.docx		Yes	Yes	Fillable Fileable
Form	6	Heart Transplant Candidate Registration_Form.xlsx	Heart Transplant Candidate Registration_Form.xlsx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

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: Not-for-profit institutions, Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	4,717	278	4,439
Annual IC Time Burden (Hours)	4,245	250	3,995
Annual IC Cost Burden (Dollars)	0	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.