Medical Clearance Update

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1405-0131 can be found here:

Documents and Forms

Document Name Document Type
Form DS03057 Medical Clearance Update Form and Instruction
DS03057 Medical Clearance Update DS3057Oct.pdf Form and Instruction
Legal Authorities_Ds 3057_08_20008.doc Legal Authorities IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Medical Clearance Update	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

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
Form and Instruction	DS03057	Medical Clearance Update	DS3057Oct.pdf		Yes	No	Fillable Printable

Line of Business: International Affairs and Commerce

Subfunction: Foreign Affairs

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 9,800	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Previously Approved
Annual Number of Responses for this IC	9,800	9,800
Annual IC Time Burden (Hours)	4,900	4,900
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Legal Authorities	Legal Authorities_Ds 3057_08_20008.doc	09/08/2008

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