Course Completion Certificate

Alternative Pilot Physical Examination and Education Requirements (BasicMed)

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2120-0770 can be found here:

Documents and Forms

Document Name Document Type
68.3b - Course Completion Certificate Regulation.docx Instruction

Information Collection (IC) Details

IC Title:	Course Completion Certificate	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 14 CFR 68

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Instruction			68.3b - Course Completion Certificate Regulation.docx		No		Fillable Fileable Signable

Line of Business: Transportation

Subfunction: Air Transportation

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 25,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Change Due to Adjustment in Agency Estimate
Annual Number of Responses for this IC	25,000	25,000
Annual IC Time Burden (Hours)	18,750	18,750
Annual IC Cost Burden (Dollars)	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.