Information Collection

Liver Transplant Candidate Registration (TCR)

IC 181739 under ICR 202506-0915-004 · OMB 0915-0157.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 24 Liver Transplant Candidate Registration_Form.xlsx Liver Transplant Candidate Registration (TCR)	Form
24. Liver Transplant Candidate Registration_Instructions.docx	Instruction
24. Liver Transplant Candidate Registration_Instructions.docx	Instruction
24. Liver Transplant Candidate Registration_Form_redline.xlsx	Other-Redline
24. Liver Transplant Candidate Registration_Form_redline.xlsx	Other-Redline
24 Liver Transplant Candidate Registration_Form.xlsx 24. Liver Transplant Candidate Registration_Form_clean.xlsx	Form
24 Liver Transplant Candidate Registration_Form.xlsx 24. Liver Transplant Candidate Registration_Form_clean.xlsx	Form

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Instruction		Yes	Yes	Fillable Fileable
Form	24	Yes	Yes	Fillable Fileable
Other-Redline		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title: Privacy Act System of Records Notice #09-15-0055

FR Citation: 87 FR 46967

Number of Respondents: 142

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 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	14,681	821	13,860
Annual IC Time Burden (Hours)	11,745	657	11,088
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
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.

Something went wrong when downloading this file. If you have any questions, please send an email to [email protected].