AVIATION MEDICAL EXAMINER APPOINTMENT APPLICATION

ICR 197804-2120-002

OMB: 2120-0002

Federal Form Document

Forms and Documents
Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
IC ID
Document
Title
Status
141084 Migrated
ICR Details
2120-0002 197804-2120-002
Historical Active 197803-2120-006
DOT/FAA
AVIATION MEDICAL EXAMINER APPOINTMENT APPLICATION
Revision of a currently approved collection   No
Regular
Approved without change 04/28/1978
Retrieve Notice of Action (NOA) 04/06/1978
  Inventory as of this Action Requested Previously Approved
06/30/1983 06/30/1983 06/30/1978
1,080 0 1,000
270 0 1,000
0 0 0

FEDERAL AVIATION ACT OF 1958, SECTION 314 (49 USC 1355), AUTHORIZES THE APPOINTMENT OF PRIVATE AVIATION MEDICAL EXAMINERS. FAA ORDER 8520.2C, AVIATION MEDICAL EXAMINER SYSTEM, PRESCRIBES REQUIREMENTS. INFORMATION COLLECTED SHOWS APPLICANT PHYSICIANS MEDICAL QUALIFICATIONS.

None
None


No

1
IC Title Form No. Form Name
AVIATION MEDICAL EXAMINER APPOINTMENT APPLICATION FAA-8520-2

  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 1,080 1,000 0 0 80 0
Annual Time Burden (Hours) 270 1,000 0 0 -730 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$0
No
No
Uncollected
Uncollected
Uncollected
Uncollected

  No

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
04/06/1978


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