Information Collection

Kidney/Pancreas Transplant Candidate Registration (TCR)

IC 181742 under ICR 202506-0915-004 · OMB 0915-0157.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 45 Kidney/Pancreas Transplant Candidate Registration_Form_clean.xlsx Kidney/Pancreas Transplant Candidate Registration (TCR)	Form
45. Kidney_Pancreas Transplant Candidate Registration_Instructions.docx	Instruction
45. Kidney_Pancreas Transplant Candidate Registration_Instructions.docx	Instruction
45. KidneyPancreas Transplant Candidate Registration_Form_redline.xlsx	Other-Redline
45. KidneyPancreas Transplant Candidate Registration_Form_redline.xlsx	Other-Redline
45 Kidney/Pancreas Transplant Candidate Registration_Form_c 45. KidneyPancreas Transplant Candidate Registration_Form_clean.xlsx	Form
45 Kidney/Pancreas Transplant Candidate Registration_Form_c 45. KidneyPancreas 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	45	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: 123

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	1,592	98	1,494
Annual IC Time Burden (Hours)	955	59	896
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.

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