Donor Organ Disposition

Data System for Organ Procurement and Transplantation Network

Documents and Forms

Document Name Document Type
69. Donor Organ Disposition_Instructions.docx Instruction
69. Donor Organ Disposition_Form_redline.xlsx Other-Redline
69 Donor Organ Disposition 69. Donor Organ Disposition_Form_clean.xlsx Form

Information Collection (IC) Details

IC Title:	Donor Organ Disposition	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			69. Donor Organ Disposition_Instructions.docx	Yes	Yes	Fillable Fileable
Form	69	Donor Organ Disposition	69. Donor Organ Disposition_Form_clean.xlsx	Yes	Yes	Fillable Fileable
Other-Redline			69. Donor Organ Disposition_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: 56	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Not-for-profit institutions, Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

	Requested	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	23,224	4,088	19,136
Annual IC Time Burden (Hours)	3,948	695	3,253
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.