Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Death Notification Referal - Eligible New 9338 1868 0 Form and Instruction Death Notification Referral _Eligible Death Notification Referral _Eligible
Death Notification Referral-Imminent New 9744 4872 0 Form and Instruction Death Notification Referral-Imminent Death Notification Referral-Imminent
Death Referral Data New 696 6960 0 Form Death Referral Data Death Referral Data
OPTN- Death Referral Removed 0 0 0 Form 2 Death Referral Data
OPTN- Deceased Donor Registration Worksheet Modified 12528 9396 0 Form 1b Imminent-Eligible Death Doc
Form 1 Deceased Donor Registration
OPTN- Donor Histocompatibility Modified 20436 2044 0 Form 5 Donor Histocompatibility
OPTN- Heart Candidate Registration Modified 4445 2223 0 Form 7 Heart Candidate Registration
Form 7b Heart Candidate Pediatric Registration
OPTN- Heart/Lung Candidate Registration Modified 102 51 0 Form 9b Heart/Lung Pediatric Registration
Form 9 Heart./Lung Candidate Registration
OPTN- Intestine Candidate Registration Modified 308 154 0 Form 24b Intestine Candidate Pediatric Registration
Form 24 Intestine Candidate Registration
OPTN- Intestine Follow-up Modified 1232 1047 0 Form 26b Intestine Pediatric Follow-up
Form 26 Intestine Follow-up
Form 26c Post 5-Year Intestine Follow-up
Form 26d Post 5-Year Intestine Pediatric Follow-up
OPTN- Intestine Registration Modified 220 198 0 Form 25b Intestine Pediatric Registration
Form 25 Intestine Registration
OPTN- Kidney Candidate Registration Modified 44103 22052 0 Form 12b Kidney Candidate Pediatric Registration
Form 12 Kidney Candidate Registration
OPTN- Kidney Follow-up Modified 178822 98352 0 Form 14b Kidney Follow-up Pediatric
Form 14 Kidney Follow-up
Form 14c Post 5-Year Kidney Follow-up
Form 14d Post 5-Year Kidney Pediatric Follow-up
OPTN- Kidney Registration Modified 20003 15002 0 Form 13b KidneyPediatric Registration
Form 13 Kidney Registration
OPTN- Kidney/Pancreas Candidate Registration Modified 2002 1001 0 Form 18b Kidney/Pancreas Pediatric Candidate Registration
Form 18 Kidney /Pancreas Candidate Registration
OPTN- Kidney/Pancreas Registration Modified 1001 901 0 Form 19 Kidney/Pancreas Registration
Form 19b Kidney/Pancreas Pediatric Registration
OPTN- Liver Candidate Registration Modified 14061 7031 0 Form 15b Liver Candidate Pediatric Registration
Form 15 Liver Candidate Registration
OPTN- Liver Follow-up Modified 66951 33476 0 Form 17b Liver Pediatric Follow-up
Form 17 Liver Follow-up
Form 17d Post 5-Year Liver Pediatric Follow-up
Form 17c Post 5-Year Liver Follow-up
OPTN- Liver Registration Modified 7482 4863 0 Form 16 Liver Registration
Form 16b Liver Pediatric Registration
OPTN- Living Donor Registration Modified 12012 7808 0 Form 3 Living Donor Registration
OPTN- Lung Candidate Registration Modified 2856 1428 0 Form 8 Lung Candidate Registration
Form 8b Lung Candidate Pediatric Registration
OPTN- Pancreas Candidate Registration Modified 1001 501 0 Form 21b Pancreas Candidate Pediatric Registration
Form 21 Pancreas Candidate Registration
OPTN- Pancreas Follow-up Modified 2860 1859 0 Form 23 Pancreas Follow-up
Form 23b Pancreas Pediatric Follow-up
Form 23c Post 5-Year Pancreas Follow-up
Form 23d Post 5-Year Pancreas Pediatric Follow-up
OPTN- Pancreas Registration Modified 429 322 0 Form 22b Pancreas Pediatric Registration
Form 22 Pancreas Registration
OPTN- Post Transplant Malignancy Modified 6840 1368 0 Form 27 Post Transplant Malignancy
Form 27b Post Transplant Pediatric Malignancy
OPTN- Recipient Histocompatibility Modified 30576 6115 0 Form 6 Recipient Histocompatibility
OPTN- Thoracic Follow-up Modified 40640 26416 0 Form 11b Thoracic Pediatric Follow-up
Form 11 Thoracic Follow-up
Form 11c Thoracic Follow-up Annual
Form 11d Thoracic Follow-up Annual Pediatric
Form 11e Post 5-Year Thoracic Follow-up
Form 11f Post 5-Year Kidney Pediatric Follow-up
OPTN- Thoracic Registration Modified 4572 3429 0 Form 10b Thoracic Pediatric Registration
Form 10 Thoracic Registration
OPTN- Kidney/Pancreas Follow-up Modified 12155 10332 0 Form 20b Kidney/Pancreas Pediatric Follow-up
Form 20 Kidney/Pancreas Follow-up
Form 20c Post 5-Year Kidney/Pancreas Follow-up
Form 20d Post 5-Year Kidney/Pancreas Pediatric Follow-up
OPTN- Living Donor Follow-up Modified 15400 7700 0 Form 4 Living Donor Follow-up
Total burden requested under this ICR: 522815 278769 0  
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