Information Collection

Medical Qualification Requirements

IC 141794 under ICR 198407-2125-001 · OMB 2125-0080.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2125-0080 can be found here:

Documents and Forms

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Information Collection (IC) Details

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IC Title:	MEDICAL QUALIFICATION REQUIREMENTS	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Migrated

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability

Line of Business:

Subfunction:

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 1	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	286,700	4,193	282,507
Annual IC Time Burden (Hours)	14,335	100	14,235
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.