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Aviation Medical Examiner Program
Aviation Medical Examiner Program
OMB: 2120-0604
IC ID: 25693
OMB.report
DOT/FAA
OMB 2120-0604
ICR 201104-2120-002
IC 25693
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2120-0604 can be found here:
2015-10-30 - Extension without change of a currently approved collection
2013-08-27 - Extension without change of a currently approved collection
Documents and Forms
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
Information Collection (IC) Details
View Information Collection (IC)
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:
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
Federal Enterprise Architecture Business Reference Module
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 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
450
0
0
0
0
450
Annual IC Time Burden (Hours)
225
0
0
0
0
225
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
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.