Information Collection Request

Medical Qualification Requirements

ICR 201710-2126-002 · OMB 2126-0006 · Historical Inactive

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form MCS 5870 Insulin Treated Diabetes Mellitus Assessment Form Form New Available
Form MCSA-5876 Medical Examiner's Certificate Revised Form Modified Available
Form MCSA-5875 Medical Examination Report Form Revised Form and Instruction Modified Available
Form MCSA-5850 CMV Driver Medical Examination Results Form Form Modified Repair queued
PRA 2126-0006 Supporting Statement for NPRM.docx Supporting Statement A Uploaded 2017-11-17 Available
2126-0006 60-day FR for the Insulin-Treated Diabetes Mellitus Assessment Form.pdf Supplementary Document Uploaded 2017-10-31 Available
PRA-2126-0006 Justification NonSubstantive Change 061416.docx Justification for No Material/Nonsubstantive Change Uploaded 2016-07-18 Available
PRA-2126-0006.Justification NonSubstantive Change final 032916.docx Justification for No Material/Nonsubstantive Change Uploaded 2016-03-30 Available
Section4116 of SAFETEA-LU(Public Law 109-59) 081005.doc Supplementary Document Uploaded 2012-04-18 Available
Section 4129 of SAFETEA-LU(PubLaw109-59.doc Supplementary Document Uploaded 2012-04-18 Available
Section 4129 of SAFETEA-LU(PubLaw109-59.doc Supplementary Document Uploaded 2010-01-22 Available
Diabetes Exemption Qualifications of Drivers (70FR67777)110805.pdf Supplementary Document Uploaded 2010-01-22 Available
Diabetes Exemption Applications Qualifications of Drivers (68FR52441)090303.pdf Supplementary Document Uploaded 2010-01-22 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
26039 C-1, Physical Qualification Standards Modified
228839 C-7, Qualifications of Drivers: Diabetes Standard Form NewInsulin Treated Diabetes Mellitus Assessment Form
220813 IC-6, Medical Examiner's Certification Integration Final Rule Form ModifiedMedical Examiner's Certificate Revised
220813 IC-6, Medical Examiner's Certification Integration Final Rule Form and Instruction ModifiedMedical Examination Report Form Revised
216256 C-4, Skill Performance Evaluation (SPE) Certificate Program Modified
216253 C-3, Medical Exemptions Modified
216251 C-2, Resolution of Medical Conflict Modified
201967 C-5, National Registry Certified Medical Examiners Form ModifiedCMV Driver Medical Examination Results Form

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
08/31/2018 36 Months From Approved 09/30/2018
34,722,151 0 34,722,151
2,633,702 0 2,633,702
0 0 0





Reginfo record details
7
table that charts list of burden
IC Title Form No. Form Name
C-1, Physical Qualification Standards
C-2, Resolution of Medical Conflict
C-3, Medical Exemptions
C-4, Skill Performance Evaluation (SPE) Certificate Program
C-5, National Registry Certified Medical Examiners MCSA-5850
C-7, Qualifications of Drivers: Diabetes Standard MCS 5870
IC-6, Medical Examiner's Certification Integration Final Rule MCSA-5875 , MCSA-5876 ,  



Reginfo record details
  No