Information Collection

Kidney/Pancreas Transplant Candidate Registration (TCR)

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

Documents and Forms

Document Name Document Type
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

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Kidney/Pancreas Transplant Candidate Registration (TCR)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Instruction			45. Kidney_Pancreas Transplant Candidate Registration_Instructions.docx	Yes	Yes	Fillable Fileable
Form	45	Kidney/Pancreas Transplant Candidate Registration_Form_clean.xlsx	45. KidneyPancreas Transplant Candidate Registration_Form_clean.xlsx	Yes	Yes	Fillable Fileable
Other-Redline			45. KidneyPancreas Transplant Candidate Registration_Form_redline.xlsx	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 %

	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

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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