OMB
.report
Search
Lung Transplant Recipient Follow Up Post 5 Year (TRF)
Data System for Organ Procurement and Transplantation Network
OMB: 0915-0157
IC ID: 226428
OMB.report
HHS/HSA
OMB 0915-0157
ICR 202202-0915-002
IC 226428
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0915-0157 can be found here:
2023-06-27 - Revision of a currently approved collection
Documents and Forms
Document Name
Document Type
Lung Transplant Recipient Follow Up Post 5 Year_Instructions.docx
Instruction
Lung Transplant Recipient Follow Up Post 5 Year_Instructions.docx
Instruction
Lung Transplant Recipient Follow Up Post 5 Year_Form_redline.xlsx
Other-Redline
Lung Transplant Recipient Follow Up Post 5 Year_Form_redline.xlsx
Other-Redline
16 Lung Transplant Recipient Follow Up Post 5 Year_Form_cle
Lung Transplant Recipient Follow Up Post 5 Year_Form_clean.xlsx
Form
16 Lung Transplant Recipient Follow Up Post 5 Year_Form_cle
Lung Transplant Recipient Follow Up Post 5 Year_Form_clean.xlsx
Form
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Lung Transplant Recipient Follow Up Post 5 Year (TRF)
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
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Instruction
Lung Transplant Recipient Follow Up Post 5 Year_Instructions.docx
Yes
Yes
Fillable Fileable
Form
16
Lung Transplant Recipient Follow Up Post 5 Year_Form_clean.xlsx
Lung Transplant Recipient Follow Up Post 5 Year_Form_clean.xlsx
Yes
Yes
Fillable Fileable
Other-Redline
Lung Transplant Recipient Follow Up Post 5 Year_Form_redline.xlsx
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:
71
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 %
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
8,271
0
0
0
0
8,271
Annual IC Time Burden (Hours)
4,963
0
0
0
0
4,963
Annual IC Cost Burden (Dollars)
0
0
0
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.