Baseline Pre-TED (Transplant Essential Data)

Stem Cell Therapeutic Outcomes Database

⚠️ Notice: This information collection may be referencing outdated material.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 1A Baseline Pre-TED (Transplant Essential Data) Form
FORM 1 - 2400 R9.docx Other-changes/adds in blue highlight
FORM 1 - 2400 R9.docx Other-changes/adds in blue highlight
1A PandemicImpactTemplate.xlsx PRE-TED PandemicImpactTemplate.xlsx Form
1A PandemicImpactTemplate.xlsx PRE-TED PandemicImpactTemplate.xlsx Form
1B FORM 1 - 2400 R8.pdf FORM 1 - 2400 R8.pdf Form
1B FORM 1 - 2400 R8.pdf FORM 1 - 2400 R8.pdf Form

Information Collection (IC) Details

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	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	1A	PandemicImpactTemplate.xlsx PRE-TED	PandemicImpactTemplate.xlsx	Yes	Yes	Fillable Fileable
Form	1B	FORM 1 - 2400 R8.pdf	FORM 1 - 2400 R8.pdf	Yes	Yes	Fillable Fileable
Other-changes/adds in blue highlight			FORM 1 - 2400 R9.docx	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	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	9,600	0	9,600
Annual IC Time Burden (Hours)	6,720	160	6,560
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.