Information Collection

Pre-Transplant Information Collection

IC 254628 under ICR 202507-0915-003 · OMB 0915-0310.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form Pre-Transplant Inf Pre-Transplant Information Collection	Form
Form Pre-Transplant Inf Pre-Transplant Information Collection Pre-Transplant Information Collection	Form
Pre-HCT Manual Final_ 10July2025.pdf	Instruction
Pre-HCT Manual Final_ 10July2025.pdf	Instruction
Pre-Transplant Inf Pre-Transplant Information Collection CIBMTR Information Collection for SCTOD to HRSA_ 10July2025.xlsx	Form
Pre-Transplant Inf Pre-Transplant Information Collection CIBMTR Information Collection for SCTOD to HRSA_ 10July2025.xlsx	Form

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

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	Pre-Transplant Information Coll Tab				Yes	Yes	Fillable Fileable
Instruction					Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title: Privacy Act System of Records #09-15-0068

FR Citation: 83 FR 6591

Number of Respondents: 182

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: 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	9,788	478	9,310
Annual IC Time Burden (Hours)	21,903	12,593	9,310
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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