Report of Eye Evaluation, Ophthalmologic Evaluation for Glaucoma

Medical Standards and Certification

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2120-0034 can be found here:

Documents and Forms

Document Name Document Type
Form 8500-7 Report of Eye Evaluation, Ophthalmologic Evaluation for Glaucoma Form and Instruction
8500-7 Report of Eye Evaluation 8500-7 with upd burden statement.pdf www.faa.gov/forms/index.cfm/go/document.information/documentID/185784 Form and Instruction

Information Collection (IC) Details

IC Title:	Report of Eye Evaluation, Ophthalmologic Evaluation for Glaucoma	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

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	8500-7	Report of Eye Evaluation	8500-7 with upd burden statement.pdf	https://www.faa.gov/forms/index.cfm/go/document.information/documentID/185784	Yes	Yes	Fillable Printable

Line of Business: Transportation

Subfunction: Air Transportation

Privacy Act System of Records
Title: Aviation Records on Individuals	FR Citation: 75 FR 68849

Number of Respondents: 6,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Requested	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	6,000	-3,000	9,000
Annual IC Time Burden (Hours)	1,500	-750	2,250
Annual IC Cost Burden (Dollars)	60,930	60,930	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.