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Course Completion Certificate
Alternative Pilot Physical Examination and Education Requirements (BasicMed)
OMB: 2120-0770
IC ID: 240834
OMB.report
DOT/FAA
OMB 2120-0770
ICR 202302-2120-002
IC 240834
( )
Documents and Forms
Document Name
Document Type
68.3b - Course Completion Certificate Regulation.docx
Instruction
68.3b - Course Completion Certificate Regulation.docx
Instruction
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Course Completion Certificate
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Unchanged
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
Federal Enterprise Architecture Business Reference Module
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
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
25,000
0
0
0
0
25,000
Annual IC Time Burden (Hours)
18,750
0
0
0
0
18,750
Annual IC Cost Burden (Dollars)
0
0
0
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.