Liver Recipient Explant Pathology Form

Data System for Organ Procurement and Transplantation Network

Documents and Forms

Document Name Document Type
Liver Recipient Explant Pathology_Instructions.docx Instruction
Liver Recipient Explant Pathology_Instructions.docx Instruction
28 Liver Explant Pathology Form.xlsx Liver Explant Pathology_form.xlsx Form
28 Liver Explant Pathology Form.xlsx Liver Explant Pathology_form.xlsx Form

Information Collection (IC) Details

IC Title:	Liver Recipient Explant Pathology Form	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Instruction			Liver Recipient Explant Pathology_Instructions.docx		Yes	Yes	Fillable Fileable
Form	28	Liver Explant Pathology Form.xlsx	Liver Explant Pathology_form.xlsx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

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

Number of Respondents: 143	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits, 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	1,044	-501	1,545
Annual IC Time Burden (Hours)	626	-301	927
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.