Information Collection

National Marrow Donor Program Donation Experience Survey

IC 264353 under ICR 202401-0915-004 · OMB 0915-0212.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 National Marrow Donor Program Donation Experience Survey	Form and Instruction
1 Donation Experience Survey 12272023 - Donation Experience Survey.docx	Form and Instruction
1 Donation Experience Survey 12272023 - Donation Experience Survey.docx	Form and Instruction
12272023 - Supporting Statement A.docx Original Generic Request A	IC Document
12272023 - Supporting Statement A.docx Original Generic Request A	IC Document

IC Title:

Agency IC Tracking Number:

IC Status: New

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	Donation Experience Survey	12272023 - Donation Experience Survey.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 1,672

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	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	1,672	1,672
Annual IC Time Burden (Hours)	217	217
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Original Generic Request A	12272023 - Supporting Statement A.docx	01/09/2024

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