Information Collection

Substance Abuse Professional (SAP) Return-to-Duty Letter for Part 67 Medical Certificate Holders

IC 228198 under ICR 202312-2120-004 · OMB 2120-0535.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2120-0535 can be found here:

Documents and Forms

Document Name Document Type
14 CFR part 120.docx www.ecfr.gov/current/title-14/chapter-I/subchapter-G/part-120 Instruction
Coordination with Privacy Office.pdf Coordination with Privacy Office IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Substance Abuse Professional (SAP) Return-to-Duty Letter for Part 67 Medical Certificate Holders	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 14 CFR 120

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Instruction			14 CFR part 120.docx	https://www.ecfr.gov/current/title-14/chapter-I/subchapter-G/part-120	Yes	Yes	Fillable Fileable

Line of Business: Transportation

Subfunction: Air Transportation

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 42	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 80 %

	Requested	Previously Approved
Annual Number of Responses for this IC	42	42
Annual IC Time Burden (Hours)	21	21
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Coordination with Privacy Office	Coordination with Privacy Office.pdf	07/29/2020

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.