OPTN Membership Application for Kidney Transplant Programs

Organ Procurement and Transplantation Network Application Form

OMB: 0915-0184

IC ID: 226681

Information Collection (IC) Details

View Information Collection (IC)

OPTN Membership Application for Kidney Transplant Programs
 
No Modified
 
Required to Obtain or Retain Benefits
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 3 OPTN Membership Application for Kidney Transplant Programs OPTN Membership Application for Kidney.docx Yes Yes Fillable Fileable
Form and Instruction 3 B OPTN Membership Application_Surgeon or Physician Log.docx OPTN Membership Application Surgeon or Physician Log.docx Yes Yes Fillable Fileable

Health Health Care Services

 

234 0
   
Private Sector Businesses or other for-profits, Not-for-profit institutions
 
   100 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 131 0 -247 0 0 378
Annual IC Time Burden (Hours) 1,048 0 -86 0 0 1,134
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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