Information Collection

BasicMed Comprensive Medical Examination Checklist - Pilot

IC 226106 under ICR 202302-2120-002 · OMB 2120-0770.

⚠️ Notice: This information collection may be referencing outdated material.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
Form 8700-2 BasicMed Comprensive Medical Examination Checklist - Pilot Form and Instruction
8700-2 BasicMed Comprehensive Medical Examination Checklist FAA_Form_8700-2.pdf www.faa.gov/documentLibrary/media/Form/FAA_Form_8700-2.pdf Form and Instruction
8700-2 BasicMed Comprehensive Medical Examination Checklist FAA_Form_8700-2.pdf www.faa.gov/documentLibrary/media/Form/FAA_Form_8700-2.pdf Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	BasicMed Comprensive Medical Examination Checklist - Pilot	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	8700-2	BasicMed Comprehensive Medical Examination Checklist	FAA_Form_8700-2.pdf	https://www.faa.gov/documentLibrary/media/Form/FAA_Form_8700-2.pdf	Yes	Yes	Fillable Fileable

Line of Business: Transportation

Subfunction: Air Transportation

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 12,500	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	12,500	0	12,500
Annual IC Time Burden (Hours)	6,250	-3,125	9,375
Annual IC Cost Burden (Dollars)	0	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.