Heart/Lung Transplant Recipient Follow Up 1-5 Year (TRF)

Data System for Organ Procurement and Transplantation Network

OMB: 0915-0157

IC ID: 214127

Information Collection (IC) Details

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Heart/Lung Transplant Recipient Follow Up 1-5 Year (TRF)
 
No Modified
 
Mandatory
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Instruction HeartLung Transplant Recipient Follow Up 1 to 5 Year_Instructions.docx Yes Yes Fillable Fileable
Form 21 Heart/Lung Transplant Recipient Follow Up 1_5 Year_Form.xlsx HeartLung Transplant Recipient Follow Up 1_5 Year_Form.xlsx Yes Yes Fillable Fileable

Health Health Care Services

Privacy Act System of Records Notice #09-15-0055  87 FR 46967

70 0
   
Private Sector Businesses or other for-profits, Not-for-profit institutions
 
   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 147 0 68 0 0 79
Annual IC Time Burden (Hours) 162 0 75 0 0 87
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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