Information Collection

IC8 - Qualification of Drivers: Vision Standard

IC 251311 under ICR 202411-2126-002 · 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⚠️ Notice: This information collection may be referencing outdated material.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 5871 IC8 - Qualification of Drivers: Vision Standard Form and Instruction
MCSA 5871 Vision Evaluation Report MCSA-5871 8-6-23 508.pdf www.fmcsa.dot.gov/regulations/medical/vision-evaluation-report-form-mcsa-5871 Form and Instruction
MCSA 5871 Vision Evaluation Report MCSA-5871 8-6-23 508.pdf www.fmcsa.dot.gov/regulations/medical/vision-evaluation-report-form-mcsa-5871 Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	IC8 - Qualification of Drivers: Vision Standard	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 49 CFR 391.41(b)(10)

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	MCSA 5871	Vision Evaluation Report	MCSA-5871 8-6-23 508.pdf	https://www.fmcsa.dot.gov/regulations/medical/vision-evaluation-report-form-mcsa-5871	Yes	Yes	Fillable Fileable Signable

Line of Business: Transportation

Subfunction: Ground Transportation

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 4,641	Number of Respondents for Small Entity: 0

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

Percentage of Respondents Reporting Electronically: 25 %

	Approved	Previously Approved
Annual Number of Responses for this IC	4,641	4,641
Annual IC Time Burden (Hours)	619	619
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.