Information Collection

IC7 -Qualification of Driver; Diabetes Standard

IC 233017 under ICR 202112-2126-001 · 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⚠️ Notice: This information collection may be referencing outdated material.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

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

Information Collection (IC) Details

View Information Collection (IC)

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:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	MCSA-5870	Insulin-Treated Diabetes Mellitus Assessment Form	itdm-assessment-form-final (1).pdf		Yes	Yes	Printable 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 %

	Requested	Previously Approved
Annual Number of Responses for this IC	4,906	4,906
Annual IC Time Burden (Hours)	654	654
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.