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⚠️ Notice: This information collection may be referencing outdated material.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

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

Information Collection (IC) Details

View Information Collection (IC)

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:

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 %

	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

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.