Information Collection

Role Delineation Study for FMCSA Medical Examiners

IC 44390 under ICR 200607-2126-002 · OMB 2126-0039.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
PRA-2126NEW.NRCME.ATTG.070606.use.doc	Other-Cover Letter and Survey Instru

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Voluntary

CFR Citation: 29 CFR 1607 49 CFR 390.5

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Cover Letter and Survey Instrument			PRA-2126NEW.NRCME.ATTG.070606.use.doc		No		Paper Only

Line of Business: Transportation

Subfunction:

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 4,000

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	4,000	4,000
Annual IC Time Burden (Hours)	4,000	4,000
Annual IC Cost Burden (Dollars)	216,000	216,000

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

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