Information Collection

IC7 -Qualification of Driver; Diabetes Standard

IC 233017 under ICR 202109-2126-001 · OMB 2126-0006.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2126-0006 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form MCSA 5870 IC7 -Qualification of Driver; Diabetes Standard	Form
MCSA 5870 Insulin-Treated Diabetes Mellitus Assessment Form itdm-assessment-form-final (1).pdf	Form
MCSA 5870 Insulin-Treated Diabetes Mellitus Assessment Form itdm-assessment-form-final (1).pdf	Form

IC Title:

IC7 -Qualification of Driver; Diabetes Standard

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 49 CFR 391.46 49 CFR 391.41(b)

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	MCSA 5870	Insulin-Treated Diabetes Mellitus Assessment Form	itdm-assessment-form-final (1).pdf		Yes	Yes	Paper Only

Line of Business: Transportation

Subfunction: Ground Transportation

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 4,906

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 25 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	4,906	0	4,906
Annual IC Time Burden (Hours)	654	0	654
Annual IC Cost Burden (Dollars)	0	-60,416	60,416

Documents for IC

table that charts IC Documents
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.