Pilot Medical Certification Customer Service Survey

ICR 199712-2120-002

OMB: 2120-0624

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
25740
Migrated
ICR Details
2120-0624 199712-2120-002
Historical Active
DOT/FAA
Pilot Medical Certification Customer Service Survey
New collection (Request for a new OMB Control Number)   No
Emergency 12/12/1997
Approved without change 12/17/1997
Retrieve Notice of Action (NOA) 12/11/1997
  Inventory as of this Action Requested Previously Approved
06/30/1998 06/30/1998
14,400 0 0
2,400 0 0
0 0 0

The Federal Aviation Administration (FAA), through the Office of Aviation Medicine (OAM), is responsible for the aeromedical certification of pilots and certain other personnel to ensure they are medically qualified to perform their duties safely. In the accomplishment of this responsibility, OAM provides a number of services to pilots and has established goals for the performance of those services. This survey will be designed to meet the requirements of the Government Performance and Results Act of 1993 (GPRA) and the Executive Order No. 12862 "Setting Customer Service Standards" which mandate surveying customers.

None
None


No

1
IC Title Form No. Form Name
Pilot Medical Certification Customer Service Survey

  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 14,400 0 0 14,400 0 0
Annual Time Burden (Hours) 2,400 0 0 2,400 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
No

$0
Yes Part B of Supporting Statement
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.
12/11/1997


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