Information Collection

Xenotransplantation Recordkeeping

IC 204780 under ICR 202109-0910-004 · OMB 0910-0456.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0910-0456 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
PHS-Guideline-Infectious-Disease-Issues-Xenotransplantation_Nov_14_2019.pdf www.fda.gov/media/73803/download	Other-PHS Guideline
PHS-Guideline-Infectious-Disease-Issues-Xenotransplantation_Nov_14_2019.pdf www.fda.gov/media/73803/download	Other-PHS Guideline

IC Title:

Xenotransplantation Recordkeeping

Agency IC Tracking Number:

CBER

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

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
Other-PHS Guideline				https://www.fda.gov/media/73803/download	Yes	Yes	Printable Only

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 5

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	207	207
Annual IC Time Burden (Hours)	55	55
Annual IC Cost Burden (Dollars)	3,660	3,660

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.

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