HOPE Act Variance Request Form

Organ Procurement and Transplantation Network Application Form

OMB: 0915-0184

IC ID: 256999

Information Collection (IC) Details

View Information Collection (IC)

HOPE Act Variance Request Form
 
No New
 
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 21 Hope Act Variance Request Form Hope Act Variance Request Form.docx Yes Yes Fillable Fileable

Health Health Care Services

 

68 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 0 0 0 0 0 0
Annual IC Time Burden (Hours) 0 0 0 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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