Heart/Lung Recipient Registration

Data System for Organ Procurement and Transplantation Network

OMB: 0915-0157

IC ID: 214124

Information Collection (IC) Details

View Information Collection (IC)

Heart/Lung Recipient Registration
 
No Modified
 
Mandatory
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Instruction HeartLung Transplant Recipient Registration_Instructions.docx Yes Yes Fillable Fileable
Form 19 Heart/Lung Transplant Recipient Registration_Form_clean.xlsx 05192023 HeartLung Transplant Recipient Registration_Form_clean.xlsx Yes Yes Fillable Fileable
Other-Redline 05192023 HeartLung Transplant Recipient Registration_Form_redline.xlsx Yes Yes Fillable Fileable

Health Health Care Services

Privacy Act System of Records Notice #09-15-0055  87 FR 46967

70 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 45 0 13 0 0 32
Annual IC Time Burden (Hours) 97 0 55 0 0 42
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
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            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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