Information Collection

Survey of Airman Satisfaction with Aeromedical Certification Services

IC 201735 under ICR 201203-2120-004 · OMB unassigned.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Survey Cover.doc medxpress.faa.gov/loginnet/Login.aspx?app=AMCS	Instruction
2120-XXXX FAA Aerospace Medical Certification Services Pilot Satis 2011 FAA Aerospace Medical Certification Services Pilot Satisfaction Survey.doc medxpress.faa.gov/loginnet/Login.aspx?app=AMCS	Form

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

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
Instruction			Survey Cover.doc	https://medxpress.faa.gov/loginnet/Login.aspx?app=AMCS	Yes	No	Printable Only
Form	2120-XXXX	FAA Aerospace Medical Certification Services Pilot Satisfaction Survey	2011 FAA Aerospace Medical Certification Services Pilot Satisfaction Survey.doc	https://medxpress.faa.gov/loginnet/Login.aspx?app=AMCS	Yes	Yes	Fillable Fileable

Line of Business: Transportation

Subfunction: Air Transportation

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 2,333

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 70 %

table that charts list of burden
	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	2,333	2,333
Annual IC Time Burden (Hours)	584	584
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.