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Baseline Pre-TED (Transplant Essential Data)
Stem Cell Therapeutic Outcomes Database
OMB: 0915-0310
IC ID: 180280
OMB.report
HHS/HSA
OMB 0915-0310
ICR 202011-0915-003
IC 180280
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0915-0310 can be found here:
2024-07-25 - No material or nonsubstantive change to a currently approved collection
2024-05-15 - No material or nonsubstantive change to a currently approved collection
Documents and Forms
Document Name
Document Type
Form 1
Baseline Pre-TED (Transplant Essential Data)
Form
11.10.2020 2400 Form R8 - Change Memo Package SCTOD OMB 0915-0310 REDLINE.docx
Other-Redline
1 PandemicImpactTemplate.xlsx PRE-TED
PandemicImpactTemplate.xlsx
Form
1 11.10.2020 2400 Form R8 - Change Memo Package SCTOD OMB
11.10.2020 2400 Form R8 - Change Memo Package SCTOD OMB 0915-0310 CLEAN.docx
Form
03.11.2020 Pre-TED Form 2400 Proposed Changes.docx
Proposed Changes Pre-TED Form
IC Document
Change Memo - Change Memo Package SCTOD OMB 0915-0310.docx
Change Memo - Change Memo Package SCTOD OMB 0915-0310
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Baseline Pre-TED (Transplant Essential Data)
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:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form
1
PandemicImpactTemplate.xlsx PRE-TED
PandemicImpactTemplate.xlsx
Yes
Yes
Fillable Fileable
Form
1
11.10.2020 2400 Form R8 - Change Memo Package SCTOD OMB 0915-0310 CLEAN.docx
11.10.2020 2400 Form R8 - Change Memo Package SCTOD OMB 0915-0310 CLEAN.docx
Yes
Yes
Fillable Fileable
Other-Redline
11.10.2020 2400 Form R8 - Change Memo Package SCTOD OMB 0915-0310 REDLINE.docx
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Health Care Services
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
200
Number of Respondents for Small Entity:
0
Affected Public:
Private Sector
Private Sector:
Not-for-profit institutions
Percentage of Respondents Reporting Electronically:
100 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
9,600
0
0
0
0
9,600
Annual IC Time Burden (Hours)
6,560
0
0
0
0
6,560
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Proposed Changes Pre-TED Form
03.11.2020 Pre-TED Form 2400 Proposed Changes.docx
03/16/2020
Change Memo - Change Memo Package SCTOD OMB 0915-0310
Change Memo - Change Memo Package SCTOD OMB 0915-0310.docx
11/30/2020
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.