Role Delineation Study for Federal Motor Carrier Safety Administration Medical Examiners

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
PRA-2126NEW.NCRME.ATTK.071306.use.pdf	Supplementary Document	Uploaded 2006-07-31	Available
PRA-2126NEW.NCRME.ATTH.070606.use.pdf	Supplementary Document	Uploaded 2006-07-31	Available
PRA-2126NEW.NRCME.SS.Part B.070606.OST.doc	Supporting Statement B	Uploaded 2006-07-31	Available
PRA-2126NEW.NRCME.ATTF.070606.use.doc	Supplementary Document	Uploaded 2006-07-31	Available
PRA-2126NEW.NRCME.ATTE.070606.use.doc	Supplementary Document	Uploaded 2006-07-31	Available
PRA-2126NEW.NRCME.ATTD.070606.use.doc	Supplementary Document	Uploaded 2006-07-31	Available
PRA-2126NEW.NRCME.ATTC.070606.use.doc	Supplementary Document	Uploaded 2006-07-31	Available
PRA-2126NEW.NRCME.ATTA&B.070606.use.doc	Supplementary Document	Uploaded 2006-07-31	Available
PRA-2126NEW.NRCME.ATTA&B.070606.use.doc	Supplementary Document	Uploaded 2006-07-31	Available
PRA-2126NEW.NRCME.SS.070606.OST.doc	Supporting Statement A	Uploaded 2006-07-31	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
44390	Role Delineation Study for FMCSA Medical Examiners	Other-Cover Letter and Survey Instrument	New

ICR Details

OMB Control No: 2126-0039	ICR Reference No: 200607-2126-002
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: DOT/FMCSA	Agency Tracking No:
Title: Role Delineation Study for Federal Motor Carrier Safety Administration Medical Examiners
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 10/06/2006
	Date Received in OIRA: 09/06/2006
Terms of Clearance: Kindly revise the statement on the consequences of the failure to display a currently valid control number to delete the phrase "Notwithstanding any other provision of law"

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	10/31/2009	09/30/2007
Responses	4,000	0	0
Time Burden (Hours)	4,000	0	0
Cost Burden (Dollars)	216,000	0	0

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Abstract: This information collection will be used to conduct a survey on the role of medical examiners who certify the physical qualifications of commercial motor vehicle (CMV) drivers.

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Authorizing Statute(s): US Code: 49 USC 31149(d) Name of Law: Medical Program
   PL: Pub.L. 109 - 59 4116 Name of Law: Motor Carrier Safety Reauthorization Act of 2005
   US Code: 49 USC 31136(a)(3) Name of Law: Minimum Safety Standards
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	70 FR 56964	09/29/2005
30-day Notice:	Federal Register Citation:	Citation Date:
	71 FR 39697	07/13/2006
Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 1

table that charts list of burden

IC Title	Form No.	Form Name
Role Delineation Study for FMCSA Medical Examiners

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ICR Summary of Burden

table that charts list of burden

	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	4,000	0	0	4,000	0	0
Annual Time Burden (Hours)	4,000	0	0	4,000	0	0
Annual Cost Burden (Dollars)	216,000	0	0	216,000	0	0

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

Burden Increase Due to: Changing Regulations

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: This new collection of information resulted in a program change of a one-time 4,000 estimated annual burden hours is support if a requirement in section 4116(a) of the Safe, Accountable, Flexible, Efficient Transportation Equity Act: A Legacy of Users (SAFETEA-LU) to verify whether a CMV driver's health meets FMCSA standards.

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Annual Cost to Federal Government: $25,000

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? Uncollected

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? Uncollected

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? Uncollected

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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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:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(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;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

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.

Certification Date: 09/06/2006

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