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Report of Eye Evaluation, Ophthalmologic Evaluation for Glaucoma
Medical Standards and Certification
OMB: 2120-0034
IC ID: 196924
OMB.report
DOT/FAA
OMB 2120-0034
ICR 202308-2120-002
IC 196924
( )
Documents and Forms
Document Name
Document Type
Form 8500-7
Report of Eye Evaluation, Ophthalmologic Evaluation for Glaucoma
Form and Instruction
8500-7 Report of Eye Evaluation
8500-7 with upd burden statement.pdf
www.faa.gov/forms/index.cfm/go/document.information/documentID/185784
Form and Instruction
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Report of Eye Evaluation, Ophthalmologic Evaluation for Glaucoma
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Unchanged
Obligation to Respond:
Mandatory
CFR Citation:
14 CFR 61
14 CFR 67
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form and Instruction
8500-7
Report of Eye Evaluation
8500-7 with upd burden statement.pdf
https://www.faa.gov/forms/index.cfm/go/document.information/documentID/185784
Yes
Yes
Fillable Printable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Transportation
Subfunction:
Air Transportation
Privacy Act System of Records
Title:
Aviation Records on Individuals
FR Citation:
75 FR 68849
Number of Respondents:
6,000
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
100 %
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
6,000
0
0
0
0
6,000
Annual IC Time Burden (Hours)
1,500
0
0
0
0
1,500
Annual IC Cost Burden (Dollars)
60,930
0
0
0
0
60,930
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.