Heart Transplant Recipient Follow Up Post 5 Year

Data System for Organ Procurement and Transplantation Network

OMB: 0915-0157

IC ID: 226418

Information Collection (IC) Details

View Information Collection (IC)

Heart Transplant Recipient Follow Up Post 5 Year
 
No Modified
 
Mandatory
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Instruction Heart Transplant Recipient Follow Up Post 5 Year_Instructions.docx Yes Yes Fillable Fileable
Form 10 Heart Transplant Recipient Follow Up Post 5 Year_Form_Clean.xlsx Heart Transplant Recipient Follow Up Post 5 Year_Form_clean.xlsx Yes Yes Fillable Fileable
Other-Redline Heart Transplant Recipient Follow Up Post 5 Year_Form_redline.xlsx Yes Yes Fillable Fileable

Health Health Care Services

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

145 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 24,810 0 3,254 0 0 21,556
Annual IC Time Burden (Hours) 12,405 0 1,627 0 0 10,778
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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.

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