Information Collection

Aviation Medical Examiner Program

IC 25693 under ICR 201104-2120-002 · OMB 2120-0604.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2120-0604 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 8520-2 Aviation Medical Examiner Program	Form and Instruction
8520-2 Aviation Medical Examiner Designation Application 8520-2.pdf	Form and Instruction

IC Title:

Aviation Medical Examiner Program

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 14 CFR 183

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
Form and Instruction	8520-2	Aviation Medical Examiner Designation Application	8520-2.pdf		No		Fillable Fileable

Line of Business: Transportation

Subfunction: Air Transportation

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 450

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	450	450
Annual IC Time Burden (Hours)	225	225
Annual IC Cost Burden (Dollars)	0	0

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.