Information Collection

Organdonor.gov Website Survey

IC 248953 under ICR 202312-0915-001 · OMB 0915-0212.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0915-0212 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 Organdonor.gov Website Survey	Form and Instruction
1 HRSA DoT Organdonor.gov Website Survey Questionnaire.doc FORM HRSA DoT Organdonor.gov Website Survey Questionnaire.docx	Form and Instruction
1 HRSA DoT Organdonor.gov Website Survey Questionnaire.doc FORM HRSA DoT Organdonor.gov Website Survey Questionnaire.docx	Form and Instruction
SUPPORTING STATEMENT HRSA DoT Organdonor.gov Website CLEAN.docx SUPPORTING STATEMENT HRSA DoT Organdonor.gov Website	IC Document
SUPPORTING STATEMENT HRSA DoT Organdonor.gov Website CLEAN.docx SUPPORTING STATEMENT HRSA DoT Organdonor.gov Website	IC Document

IC Title:

Organdonor.gov Website Survey

Agency IC Tracking Number:

IC Status: Unchanged

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	1	HRSA DoT Organdonor.gov Website Survey Questionnaire.docx	FORM HRSA DoT Organdonor.gov Website Survey Questionnaire.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 400

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Requested	Previously Approved
Annual Number of Responses for this IC	400	400
Annual IC Time Burden (Hours)	67	67
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
SUPPORTING STATEMENT HRSA DoT Organdonor.gov Website	SUPPORTING STATEMENT HRSA DoT Organdonor.gov Website CLEAN.docx	08/19/2021

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