View Information Collection (IC)

View Information Collection (IC)

View Information Collection (IC)

IC Title:	Pre-Transplant Information Collection	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	Pre-Transplant Information Coll Tab	Pre-Transplant Information Collection	CIBMTR Information Collection for SCTOD to HRSA_ 10July2025.xlsx		Yes	Yes	Fillable Fileable
Instruction			Pre-HCT Manual Final_ 10July2025.pdf		Yes	Yes	Fillable Fileable

Federal Enterprise Architecture Business Reference Module

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title: Privacy Act System of Records #09-15-0068	FR Citation: 83 FR 6591

Number of Respondents: 182	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: 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	9,788	0	478	0	0	9,310
Annual IC Time Burden (Hours)	21,903	0	12,593	0	0	9,310
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.