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Application for Airman Medical Certificate or Airman Medical and Student Pilot Certificate
Medical Standards and Certification
OMB: 2120-0034
IC ID: 196926
OMB.report
DOT/FAA
OMB 2120-0034
ICR 201601-2120-004
IC 196926
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2120-0034 can be found here:
2023-08-03 - Revision of a currently approved collection
2022-11-23 - Revision of a currently approved collection
Documents and Forms
Document Name
Document Type
Form 8500-8
Application for Airman Medical Certificate or Airman Medical and Student Pilot Certificate
Form and Instruction
8500-8 Application for Airman Medical Certificate or Airman Med
8500-8_PRA revised.pdf
medxpress.faa.gov/
Form and Instruction
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Application for Airman Medical Certificate or Airman Medical and Student Pilot Certificate
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 67
14 CFR 61
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form and Instruction
8500-8
Application for Airman Medical Certificate or Airman Medical and Student Pilot Certificate
8500-8_PRA revised.pdf
https://medxpress.faa.gov/
Yes
Yes
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:
378,782
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
100 %
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
378,782
0
0
-17,518
0
396,300
Annual IC Time Burden (Hours)
568,173
0
0
-26,277
0
594,450
Annual IC Cost Burden (Dollars)
13,469,488
0
0
-32,897,612
0
46,367,100
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.