Information Collection

IC5b - National Registry of Certified Medical Examiners - CMV Driver Medical Examination Results

IC 251308 under ICR 202507-2126-009 · OMB 2126-0006.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form MCSA-5850 IC5b - National Registry of Certified Medical Examiners - CMV Driver Medical Examination Results	Form and Instruction
Form MCSA-5850 CMV Driver Medical Examination Results Form IC5b - National Registry of Certified Medical Examiners - CMV Driver Medical Examination Results	Form and Instruction
MCSA-5850 CMV Driver Medical Examination Results Form MCSA-5850 7-18-25 508.pdf	Form and Instruction
MCSA-5850 CMV Driver Medical Examination Results Form MCSA-5850 7-18-25 508.pdf	Form and Instruction

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 49 CFR 391.41

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	MCSA-5850				Yes	Yes	Fillable Fileable Signable

Line of Business: Transportation

Subfunction: Ground Transportation

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 52,952

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	13,914,850	13,914,850
Annual IC Time Burden (Hours)	284,489	284,489
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
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.

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