View Information Collection Request (ICR) Package

Please note that the OMB number and expiration date may not have been determined when this Information Collection Request and associated Information Collection forms were submitted to OMB. The approved OMB number and expiration date may be found by clicking on the Notice of Action link below.

View ICR - OIRA Conclusion

OMB Control No: 0915-0184	ICR Reference No: 201403-0915-002
Status: Historical Active	Previous ICR Reference No: 201102-0915-005
Agency/Subagency: HHS/HSA	Agency Tracking No: 21566
Title: Organ Procurement and Transplantation Network Application Form
Type of Information Collection: Revision of a currently approved collection	Common Form ICR: No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 05/16/2014
Retrieve Notice of Action (NOA)	Date Received in OIRA: 03/17/2014
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	05/31/2017	36 Months From Approved	05/31/2014
Responses	1,547	0	36,868
Time Burden (Hours)	6,006	0	23,503
Cost Burden (Dollars)	0	0	0

ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to Agency Discretion	Change Due to Adjustment in Estimate
Annual Number of Responses	1,547	36,868	-36,404	1,083
Annual Time Burden (Hours)	6,006	23,503	-17,497	0
Annual Cost Burden (Dollars)	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: Yes

Burden Reduction Due to: Changing Forms

Short Statement: This renewal request is made with revisions to the expiring documents. The paperwork burden is decreasing. The application forms were revised to make them more respondent friendly. Specifically, the revised application is rewritten in plain language and asks only for information relevant to current membership requirements. It is estimated that the number of respondents will increase significantly. First, there will be more individual forms to fill out. However, each individual form will be shorter and easier to complete - therefore, the burden will not be increased. In addition, some membership application activities are being formalized with the development of two new data collection forms: o F Change in Histocompatibility Lab Director; and o G Change in OPO Key Personnel Although two new data forms have been developed, membership obligations have always required that this information be formally reported to the OPTN; as such, the new forms referenced above will not create a new burden for OPTN members.