OMB
.report
Search
Heart/Lung Post Transplant Malignancy (PTM) Form
Data System for Organ Procurement and Transplantation Network
OMB: 0915-0157
IC ID: 226431
OMB.report
HHS/HSA
OMB 0915-0157
ICR 202202-0915-002
IC 226431
( )
⚠️ Notice: This information collection may be referencing outdated material.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
HeartLung Post Transplant Maligancy_Instructions.docx
Instruction
HeartLung Post Transplant Maligancy_Instructions.docx
Instruction
23 Heart/Lung Post Transplant Malignancy_Form.xlsx
HeartLung Post Transplant Malignancy_Form.xlsx
Form
23 Heart/Lung Post Transplant Malignancy_Form.xlsx
HeartLung Post Transplant Malignancy_Form.xlsx
Form
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Heart/Lung Post Transplant Malignancy (PTM) Form
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
HeartLung Post Transplant Maligancy_Instructions.docx
Yes
Yes
Fillable Fileable
Form
23
Heart/Lung Post Transplant Malignancy_Form.xlsx
HeartLung Post Transplant Malignancy_Form.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:
69
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
21
0
0
0
0
21
Annual IC Time Burden (Hours)
8
0
0
0
0
8
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.