OMB
.report
Search
Ophthalmological Evaluation for Glaucoma
Medical Standards and Certification
OMB: 2120-0034
IC ID: 211732
OMB.report
DOT/FAA
OMB 2120-0034
ICR 201703-2120-001
IC 211732
( )
⚠️ Notice: This information collection may be referencing outdated material.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 8500-14
Ophthalmological Evaluation for Glaucoma
Form
8500-14 Ophthalmological Evaluation for Glaucoma
8500-14_PRA revised.pdf
medxpress.faa.gov/
Form
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Ophthalmological Evaluation for Glaucoma
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Unchanged
Obligation to Respond:
Required to Obtain or Retain Benefits
CFR Citation:
14 CFR 61
14 CFR 67
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form
8500-14
Ophthalmological Evaluation for Glaucoma
8500-14_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:
9,000
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
9,000
0
0
0
0
9,000
Annual IC Time Burden (Hours)
2,250
0
0
0
0
2,250
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.