Information Collection

OPTN Membership Application for Vascularized Composite Allograft (VCA) Transplant Programs

IC 226687 under ICR 202512-0915-001 · OMB 0915-0184.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 8 OPTN Membership Application for Vascularized Composite Allograft (VCA) Transplant Programs	Form and Instruction
Form 8 OPTN Membership Application for Vascularized Composite Allograft (VCA) Transplant Programs OPTN Membership Application for Vascularized Composite Allograft (VCA) Transplant Programs	Form and Instruction
8 OPTN Membership Application for Vascularized Composite A 08_OPTN Membership Application for VCA Transplant Programs_CLEAN.docx	Form and Instruction
8 OPTN Membership Application for Vascularized Composite A 08_OPTN Membership Application for VCA Transplant Programs_CLEAN.docx	Form and Instruction

Information Collection (IC) Details

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IC Title:

OPTN Membership Application for Vascularized Composite Allograft (VCA) Transplant Programs

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 and Instruction	8				Yes	Yes	Fillable Fileable

Federal Enterprise Architecture Business Reference Module

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title: Organ Procurement and Transplantation Network (OPTN)/ Scientific Registry of Transplant Recipients (SRTR) Data System, HHS/ HRSA/HSB/DoT, 09-15-0055

FR Citation: 87 FR 46967

Number of Respondents: 48

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	13	-29	42
Annual IC Time Burden (Hours)	309	-342	651
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
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Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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