Organ Procurement and Transplantation Network Application

Organ Procurement and Transplantation Network

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0915-0184 can be found here:

Documents and Forms

Document Name Document Type
Form 0 Organ Procurement and Transplantation Network Application Form
B1_Cover_Instuctions_Add on program_20071109.pdf www.optn.org Instruction
0 0 A1_Full Appl_Cover_instructions_20071109.pdf www.optn.org Form and Instruction
0 0 A2_Part 1_2_General_Facility.pdf www.optn.org Form
0 0 A3_KI_LDK_combined appl.pdf www.optn.org Form
0 0 A4_LI_LDL_combined_appl.pdf www.optn.org Form
0 0 A5_PA_appl.pdf www.optn.org Form
0 0 A6_HR_appl.pdf www.optn.org Form
0 0 A7_LU_appl.pdf www.optn.org Form
0 0 C_OPO_application_independent_revised.pdf www.optn.org Form
0 0 A8_HL_appl.pdf www.optn.org Form
0 0 A9_PI_appl.pdf www.optn.org Form
0 0 A10_LDK_TX_program_appl_initial only.pdf www.optn.org Form
0 0 A11_Part 5_OPO_inhouse.pdf www.optn.org Form
0 0 A12_Lab_Section_Part 6_Full Appl.pdf www.optn.org Form
0 0 B2_New_LDL_only_Cover_Instructions_Add on program.pdf www.optn.org Form
0 0 E_Lab_Independent_Application_revised.pdf www.optn.org Form
0 0 D_LAB_inhouse_full_appl_cover & Instructions_revised.pdf www.optn.org Form

Information Collection (IC) Details

IC Title:	Organ Procurement and Transplantation Network Application	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 42 CFR 121

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	0	0	E_Lab_Independent_Application_revised.pdf	www.optn.org	Yes	No	Printable Only
Form and Instruction	0	0	A1_Full Appl_Cover_instructions_20071109.pdf	www.optn.org	Yes	No	Printable Only
Form	0	0	A2_Part 1_2_General_Facility.pdf	www.optn.org	Yes	No	Printable Only
Form	0	0	A3_KI_LDK_combined appl.pdf	www.optn.org	Yes	No	Printable Only
Form	0	0	A4_LI_LDL_combined_appl.pdf	www.optn.org	Yes	No	Printable Only
Form	0	0	A5_PA_appl.pdf	www.optn.org	Yes	No	Printable Only
Form	0	0	A6_HR_appl.pdf	www.optn.org	Yes	No	Printable Only
Form	0	0	A7_LU_appl.pdf	www.optn.org	Yes	No	Printable Only
Form	0	0	C_OPO_application_independent_revised.pdf	www.optn.org	Yes	No	Printable Only
Form	0	0	A8_HL_appl.pdf	www.optn.org	Yes	No	Printable Only
Form	0	0	A9_PI_appl.pdf	www.optn.org	Yes	No	Printable Only
Form	0	0	A10_LDK_TX_program_appl_initial only.pdf	www.optn.org	Yes	No	Printable Only
Form	0	0	A11_Part 5_OPO_inhouse.pdf	www.optn.org	Yes	No	Printable Only
Form	0	0	A12_Lab_Section_Part 6_Full Appl.pdf	www.optn.org	Yes	No	Printable Only
Instruction			B1_Cover_Instuctions_Add on program_20071109.pdf	www.optn.org	Yes	No	Printable Only
Form	0	0	B2_New_LDL_only_Cover_Instructions_Add on program.pdf	www.optn.org	Yes	No	Printable Only
Form	0	0	D_LAB_inhouse_full_appl_cover & Instructions_revised.pdf	www.optn.org	Yes	No	Printable Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 40	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	40	-36,417	36,457
Annual IC Time Burden (Hours)	1,800	-17,659	19,459
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.