Heart Post-Transplant Malignancy Form

Data System for Organ Procurement and Transplantation Network

OMB: 0915-0157

IC ID: 226422

Information Collection (IC) Details

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Heart Post-Transplant Malignancy Form
 
No Modified
 
Mandatory
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Instruction Heart Post Transplant Maligancy_Instructions.docx Yes Yes Fillable Fileable
Form 11 Heart Post Transplant Malignancy_Form.xlsx Heart Post Transplant Malignancy_Form.xlsx Yes Yes Fillable Fileable

Health Health Care Services

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

145 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 1,910 0 122 0 0 1,788
Annual IC Time Burden (Hours) 1,719 0 110 0 0 1,609
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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