An Information Collection Request (ICR) is a federal agency's request for approval from the Office of Management and Budget (OMB) to collect information from the public.
Under the Paperwork Reduction Act (PRA), agencies must justify why the information is needed and how it will be used.
Federal agencies are required to submit an ICR whenever they create, renew, modify, or discontinue an information collection. Each ICR includes a description of the collection,
supporting materials and documentation (such as forms, surveys, or scripts), and proof that the agency has met the requirements of the PRA.
The ICR is submitted to the The Office of Information and Regulatory Affairs (OIRA) within OMB for review and approval. OIRA grants approval for a maximum of three years, after
which the collection must be renewed through a new ICR submission.
ICRs are publicly available on RegInfo.gov, and additional guidance can be found in the FAQs.
Note: Presidential Action influences are notated for ICRs received between January 20, 2025 and July 19, 2025.
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| 202509-0712-005 | Marine Corps Installations Pacific School Visit Program Application | DOD/USMC | 2025-09-23 | Received in OIRA | New collection (Request for a new OMB Control Number)
Marine Corps Installations Pacific School Visit Program Application
Key Information
Abstract
Information collection via the MCIPAC-MCBB Form 5726/1, “School Visit Program Application,” is necessary to allow local Japanese students to request to visit Marine Corps Bases in Okinawa. The information will be used as part of the school visit program to tailor the specific needs of students when visiting U.S. bases. The form is prepared by the MCIPAC-MCBB, G-7 School Visit Program Manager and filled out by the requesting school’s staff facilitators. The MCIPAC-MCBB G-7 facilitates a school visit program for Host Nation Japanese school students. The program is designed to allow school age children an opportunity to experience American culture and familiarize themselves with the mission of the U.S. Military. |
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| 202509-0925-001 | Conference, Meeting, Workshop, Registration and Challenges Generic Clearance (OD) | HHS/NIH | 2025-09-23 | Received in OIRA | Extension without change of a currently approved collection
Conference, Meeting, Workshop, Registration and Challenges Generic Clearance (OD)
Key Information
Abstract
This is an extension of a currently approved generic clearance which allows NIH to continue to request detailed information from organizations (universities, non-profits, etc.) when there is a need to gather information for various activities. This generic provides a quick and efficient process to create registration forms for NIH sponsored conference, meetings, workshops, poster sessions, presentations, panels, and website content. The National Institutes of Health (NIH) directly sponsors, organizes, and conducts research-related activities such as conferences, workshops, meetings, poster sessions, and training courses. These activities are designed to be relevant to the current state of research in each field or to the current state of participant’s research projects or careers, and other resource limitations and determine the number of possible participants. For such activities to be timely and to optimally use available resources to address needs and opportunities within the research community, it is necessary for NIH to have a means to register and select the most appropriate participants, according to the type or purpose of a given activity. |
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| 202509-0915-003 | Medicare Rural Hospital Flexibility Grant Program Performance Measures | HHS/HSA | 2025-09-22 | Received in OIRA | Revision of a currently approved collection
Medicare Rural Hospital Flexibility Grant Program Performance Measures
Key Information
Authorizing Statutes
Abstract
The Flex Program enables state designated entities to support critical access hospitals (CAHs) in quality improvement, quality reporting, performance improvement, and benchmarking; to assist facilities seeking designation as critical access hospitals; and to create a program to establish or expand the provision of rural emergency medical services (EMS). These initiatives are meant to ensure residents in rural communities have access to high quality health care services. These initiatives cover the following program areas: quality improvement; financial and operational improvement; population health and EMS improvement; critical access hospital (CAH) conversion; and integration of innovative care models. Flex program performance measures were developed with stakeholder feedback to provide aggregate program data required by Congress under the Government Performance and Results Modernization Act of 2010. The information collected is used for identifying and understanding programmatic improvement across program areas, as well as guiding future iterations of the Flex Program and prioritizing areas of need and support. |
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| 202509-0693-002 | Malcolm Baldrige National Quality Award and Examiner Applications | DOC/NIST | 2025-09-22 | Received in OIRA | Extension without change of a currently approved collection
Malcolm Baldrige National Quality Award and Examiner Applications
Key Information
Abstract
The Malcolm Baldrige National Quality Improvement Act of 1987, Public Law 100-107, established an annual U.S. National Quality Award (Award). The purposes of the Award are to promote competitiveness and quality awareness, recognize the performance achievements of U.S. companies, and to share successful strategies and practices. |
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| 202509-0970-006 | National Communication System for Runaway and Homeless Youth Data Collection | HHS/ACF | 2025-09-22 | Active | No material or nonsubstantive change to a currently approved collection
National Communication System for Runaway and Homeless Youth Data Collection
Key Information
Abstract
The Family and Youth Services Bureau’s (FYSB) Runaway and Homeless Youth Division has a legislative requirement to fund a National Communication System, which is currently operated by the National Runaway Safeline (NRS). The NRS provides information, referral services, crisis intervention, and prevention resources to vulnerable youth and families of youth at risk of running away and/or becoming homeless at no cost. When necessary, the NRS refers runaway and homeless youth to shelters, counseling, medical assistance, and other vital services. The NRS collects information from all contacts with youth and adults connecting with the NRS (i.e., parents, family members, legal guardians, service providers) on a voluntary basis to inform crisis services and develop an annual report on the information collected during calls, chats, emails, and forum posts from young people who reached out to the NRS’s crisis services. The Runaway and Homeless Youth Act (RHYA), as reauthorized by the Reconnecting Homeless Youth Act of 2008 (P.L.110-378) through FY 2013 and more recently reauthorized by the Juvenile Justice Reform Act through FY 2019, mandates the Secretary shall make grants for a national communication system to assist runaway and homeless youth in communicating with their families and with service providers. The NRS is required to have a system for collecting and analyzing data on calls, emails, chat, texts, and online messages received as well as other information, such as prevention resources, referrals, demographics, and visitors to the NRS website. The NRS must submit monthly and semi-annual reports that includes the following: • Number of calls received, answered, and missed. • Number of chats, emails, and texts received; number of chats, emails, and texts answered; and number of chats, emails, and texts that were missed and did not receive a response, in which the users are youth in crisis, runaway youth, and youth experiencing homelessness. • Number of parents, legal guardians, and service providers contacting the NRS and the type of resources, interventions, and technical support/assistance requested and provided. • Number and type of prevention materials disseminated to communities, especially to underserved populations. • Number and type of unique visitors to the NRS’ website. • Information on referrals provided and where youth were referred for services. • Information on the callers' or users' demographics and where they were located when contacting the NRS. • Information on the prevention materials developed and disseminated by the NRS. • Information and analysis of the latest trends and their impact on runaway prevention. The NRS uses two forms, one form to collect relevant information disclosed during calls, emails, and forum posts, and then a second form to collect information from chats. All data will be provided to FYSB in the aggregate and no personally identifiable information are collected. This nonsubstantive change request is in response to the Defending Women from Gender Ideology Extremism and Restoring Biological Truth to the Federal Government Executive Order (Defending Women EO). ACF has implemented changes to update gender collected data to denote sex as a biological variable in current approved information collection requests to comply with the directives. This request is specific to only these updates. |
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| 202508-2127-005 | National Roadside Survey of Alcohol and Drug Prevalence of Road Users: 2025 | DOT/NHTSA | 2025-09-22 | Received in OIRA | New collection (Request for a new OMB Control Number)
National Roadside Survey of Alcohol and Drug Prevalence of Road Users: 2025
Key Information
Abstract
National Roadside Surveys (NRSs) are a central tool in understanding alcohol- and drug-involved driving. Starting in 1973, roadside surveys of drivers on the road have estimated the population-level prevalence of drinking and driving in the United States. The core methodology has continued across decades, but NHTSA has initiated improvements. The number of sites has increased, drugs of interest have been modified to reflect use across the country, and advances in technology have impacted how data can be collected and specimens analyzed. Conducting an NRS on a periodic basis (e.g., about every 10 years) allows NHTSA to examine the prevalence of alcohol and drug use among drivers, and trends across survey years. Given States are legalizing medicinal and/or recreational use of cannabis, and other issues such as the apparent increase in opioid use in the U.S., more information is needed on the level of alcohol- and drug-involved driving to better inform NHTSA’s countermeasure development. Roadside surveys provide objective measures of alcohol and drugs in drivers’ systems when they are actually driving. These measures are based on results from breath tests and oral fluid samples collected using established protocols. Analyses of these specimens allow for the quantitative determination of alcohol and drug levels. Learning more about alcohol and other drug prevalence among road users other than drivers is new to this NRS. These other road users (ORUs) include pedestrians, bicyclists, scooterists, and those using mobility aids. NHTSA will conduct two studies. Study 1 will focus on drivers but include convenience sampling of ORUs passing by the data collection locations. Study 2 is a pilot test assessing the feasibility of a NRS specific to ORUs. Both will collect breath and oral fluid specimens, demographic information, and self-report questionnaire data on roads across the country. Participation will be voluntary and anonymous. Study protocols will be reviewed by a U.S. Department of Health and Human Services-approved IRB. The only personal identifiable information (PII) collected is oral fluid. No DNA analyses will be conducted on the oral fluid specimens. These will only be analyzed for the presence of alcohol and other drugs, and specimens will be destroyed after the study is complete. The results will be reported in aggregate form in research reports. NHTSA anticipates obtaining a Certificate of Confidentiality from the National Institutes of Health (NIH). Study 1 / National Roadside Survey. This request is a voluntary, one-time survey. This survey follows the prior NRS methodology but additionally includes recruiting ORUs who are passing by data collection locations. Data collection will occur in 60 primary sampling units (PSUs) using 5 locations at each PSU (300 locations total). There will be a single data collection event at each location. The biological samples will be sent to a toxicology lab for testing of the presence of alcohol and other drugs. Participants’ responses to survey questions on the use of drugs and traffic safety-related behaviors and attitudes will also be analyzed. Study 2 / Pilot Test for Other Road Users. Study 2 examines the viability of a stand-alone roadside survey focused solely on ORUs. This effort uses 20 new data collection locations, inclusive of 4 PSUs with 5 locations each. This effort is to inform NHTSA on the feasibility of such a targeted roadside survey and to determine the level of effort to execute a nationwide study of ORUs. The same procedures as Study 1 will be used. NHTSA will use the information from both studies to produce technical reports presenting the findings. The technical reports will provide only aggregate (summary) statistics and tables; no PII will be retained or reported. The Study 1 technical report is for audiences interested in traffic safety. The information from Study 2 will also be used by NHTSA in consideration of research on ORUs. |
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| 202509-0920-002 | [NCIPC] Performance Monitoring of CDC’s Comprehensive Suicide Prevention Program | HHS/CDC | 2025-09-22 | Received in OIRA | Revision of a currently approved collection
[NCIPC] Performance Monitoring of CDC’s Comprehensive Suicide Prevention Program
Key Information
Abstract
The request is to reflect the addition of seven (7) new recipients. In September 2023, additional recipients were added to the Comprehensive Suicide Prevention Program. Recipients are required to develop a strategic action plan that outlines their comprehensive approach to suicide prevention and then to implement and evaluate this approach. This ICR collects performance monitoring data via a web-based Partners’ Portal. This data is needed to monitor the cooperative agreement program funded under the Comprehensive Suicide Prevention Program. This Revision includes an additional instrument and other minor changes. |
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| 202509-0920-003 | [NCHS] National Health Interview Survey | HHS/CDC | 2025-09-22 | Active | No material or nonsubstantive change to a currently approved collection
[NCHS] National Health Interview Survey
Key Information
Abstract
DHIS collects on an annual basis, statistically valid data on the amount, distribution, and effects of illness and disability in the population and on the utilization of health care services for such conditions. NHIS data are used widely throughout the Department of Health and Human Services (DHHS) to monitor trends in illness and disability and to track progress toward achieving many of the health objectives for the nation. This Revision includes updated Survey information and burden edits. The current design of the NHIS questionnaire, implemented in 2019, features a rotational schedule consisting of annual core, rotating core, emerging content, and sponsored content modules. This change request is submitted to accommodate changing field conditions and declining response rates. |
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| 202507-2126-009 | Medical Qualification Requirements | DOT/FMCSA | 2025-09-22 | Received in OIRA | No material or nonsubstantive change to a currently approved collection
Medical Qualification Requirements
Key Information
Abstract
This request for a non-substantive change to this ICR updates the expiration dates to the five collection instruments associated with this ICR. The information collection requirements are mandatory and apply to drivers, motor carriers, MEs, ME applicant testing organizations, and TCs. IC-1: Physical Qualification Standards; MEs must provide driver medical exam information for drivers they examine on medical forms and in the National Registry. The ME can determine if the driver is medically qualified. The ME must complete and furnish the original paper MEC to the driver. The driver must complete driver health history portion of the MER Form at least every 2 years. The motor carrier must file a MEC in DQ record. IC-2: Resolution of Medical Conflict; The medical conflict application provision provides a mechanism for drivers and motor carriers to request FMCSA to make a final decision to resolve conflicting medical evaluations when either party does not accept the decision of a medical specialist. FMCSA uses the information to determine if the driver should or should not be qualified. Motor carriers are required to submit an application to FMCSA for resolution (up to 3 cases a year) and attend a hearing (1 per year) if FMCSA deems necessary. IC-3: Medical Exemptions; FMCSA may grant a vision, hearing, or seizure exemption from a physical qualification standard. The driver is to complete an application for new exemption and exemption renewal every 2 years and the motor carrier is to copy and file the exemption in the DQ file. IC4: Skill Performance Evaluation Certificate; The SPE Certificate program requires drivers to complete an application for the new SPE certificate, complete an application for SPE certificate renewal every 2 years, provide a copy of the MER Form and MEC to FMCSA, and for motor carriers to copy and file the SPE Certificate in the DQ record. IC-5: National Registry of Certified Medical Examiners; MEs are required to provide contact and employment data when registering to become a certified ME. This data is used to provide the public with contact information for those medical professionals who are certified by FMCSA to conduct interstate CMV driver medical exams. MEs are required to submit the results of each CMV driver medical exam they complete daily, copies of MER forms, and MECs via the National Registry. IC-6: Medical Examiner’s Certification Integration Final Rule; Beginning on June 23, 2025, MEs will no longer be required to complete and furnish the original written MEC to qualified drivers when the driver is a CDL/CLP holder. This information will be electronically transmitted to the SDLA. Employers will no longer need to request a copy of the handwritten MEC for CDL/CLP holders. In addition, employers will no longer be required to verify the ME’s National Registry number for MECs issued to CDL/CLP holders because only MEs listed on the National Registry will be able to forward MEC information to the National Registry. IC-7: Qualifications of Drivers; Diabetes Standard; An individual with ITDM is able to obtain an MEC from an ME for up to a maximum of 12 months if the TC, the healthcare professional who manages, and prescribes insulin for the treatment of the individual’s diabetes, attests to the ME the individual maintains a stable insulin regimen and proper control of diabetes, and the ME determines the individual meets FMCSA’s physical qualification standards. The information provided by the TC enables the ME to make a qualification determination based on whether the driver meets all the physical qualification requirements. |
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| 202509-0920-006 | [NCHHSTP] Expanding PrEP in Communities of Color (EPICC) | HHS/CDC | 2025-09-22 | Active | No material or nonsubstantive change to a currently approved collection
[NCHHSTP] Expanding PrEP in Communities of Color (EPICC)
Key Information
Abstract
The purpose of this study is to implement and evaluate the effectiveness of a clinic-based intervention that utilizes evidence-based education and support tools to 1) increase provider knowledge of and comfort with HIV preexposure prophylaxis (PrEP) modalities in clinical practice and 2) improve PrEP adherence among young men and non-binary persons who have sex with men (YMSM). This Change Request is submitted to modify language to comply with EO 14168. There is no anticipated change to the approved burden. |
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| 202509-3041-003 | Safety Standard for Omnidirectional Citizens Band Base Station Antennas, 16 CFR Part 1204 | CPSC | 2025-09-22 | Received in OIRA | Revision of a currently approved collection
Safety Standard for Omnidirectional Citizens Band Base Station Antennas, 16 CFR Part 1204
Key Information
Abstract
The Safety Standard for Omnidirectional Citizens Band Base Station Antennas established requirements to reduce risks of death injury resulting from accidental contact of a CB base station antenna with overhead power lines. Certification regulations require manufacturers, importers, and private labelers of those antennas to test their products for compliance with the standard and to maintain records of testing. |
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| 202509-2125-001 | Risk-Based Asset Management Plans | DOT/FHWA | 2025-09-22 | Received in OIRA | New collection (Request for a new OMB Control Number)
Risk-Based Asset Management Plans
Key Information
Authorizing Statutes
23 USC 119(e)(5) (View Law) 23 USC 119(e)(6) (View Law) 23 USC 119(e) (View Law) Pub.L. 117 - 58 11105(3) (View Law) 23 USC 119(e)(4)(D) (View Law) Abstract
Under 23 U.S.C. 119(e) and implementing regulations at 23 CFR part 515, State departments of transportation (State DOTs) are required to develop Risk-Based asset management plans (AMPs) for the National Highway System (NHS) to improve or preserve the condition of the assets and the performance of the NHS. As part of this requirement, each State DOT must annually submit information to FHWA that demonstrates that the State DOT has implemented an AMP that meets the requirements of 23 U.S.C. 119(e) and 23 CFR part 515, and every 4 years, each State DOT must submit its processes for the development of its AMP to FHWA for certification and recertification every four years following the year of initial certification (23 U.S.C. 119(e)(6)). Section 11105(3) of the Bipartisan Infrastructure Law (Public Law 117-58) added a requirement that the required risk management and lifecycle cost analyses in AMPs consider extreme weather and resilience. A State DOT not in compliance with these requirements receives a penalty in the form of reduced Federal share for projects carried out under the National Highway Performance Program. |
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| 202506-1220-003 | Job Openings and Labor Turnover Survey (JOLTS) | DOL/BLS | 2025-09-22 | Received in OIRA | Extension without change of a currently approved collection
Job Openings and Labor Turnover Survey (JOLTS)
Key Information
Abstract
The Job Openings and Labor Turnover Survey collects data on job vacancies, labor hires, and labor separations. The data can be used as demand-side indicators of labor shortages. These indicators of labor shortages at the national level greatly enhance policy makers' understanding of imbalances between the demand and supply of labor. Presently there is no other economic indicator of labor demand with which to assess the presence of labor shortages in the U.S. labor market. The availability of unfilled jobs is an important measure of tightness of job markets, symmetrical to unemployment measures. |
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| 202507-0910-008 | Tobacco Products, Exemptions From Substantial Equivalence Requirements | HHS/FDA | 2025-09-22 | Received in OIRA | Extension without change of a currently approved collection
Tobacco Products, Exemptions From Substantial Equivalence Requirements
Key Information
Abstract
FDA has established in its regulations a pathway for manufacturers to request exemptions from the substantial equivalence requirements of the FD&C Act. An exemption request must be submitted with supporting documentation, the manufacturer's contact information, and a detailed explanation of the modification and its purpose. This information is submitted to FDA so FDA can determine whether an exemption from substantial equivalence to the predicate product is appropriate for the protection of the public health. FDA determines whether to grant or deny the request for an exemption based on whether the criteria in the statute have been satisfied. If FDA determines that the information is insufficient, FDA may request additional information from the manufacturer. If the manufacturer fails to respond within the timeframe requested, FDA will consider the exemption request withdrawn. FDA may rescind an exemption where necessary to protect the public health. FDA may exempt tobacco products that are modified by adding or deleting a tobacco additive, or increasing or decreasing the quantity of an existing tobacco additive, from the requirement of demonstrating substantial equivalence if the Agency determines that (1) the modification would be a minor modification of a tobacco product, (2) a report demonstrating substantial equivalence is not necessary for the protection of public health, and (3) an exemption is otherwise appropriate. |
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| 202505-1506-002 | Beneficial Ownership Information Reporting Requirements | TREAS/FINCEN | 2025-09-22 | Received in OIRA | Revision of a currently approved collection
Beneficial Ownership Information Reporting Requirements
Key Information
Abstract
On March 26, 2025, FinCEN issued an interim final rule entitled “Beneficial Ownership Information Reporting Requirement Revision and Deadline Extension”(IFR). The IFR revised the information collection requirements in 31 CFR 1010.380, and FinCEN is submitting this information collection request to support revisions to 31 CFR 1010.380. The attached supporting statement, included with this information collection request, identifies the estimated burden hours for the OMB control number associated with these revised requirements. |
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| 202509-0938-019 | Pre-Claim Review Demonstration For Home Health Services (CMS-10599) | HHS/CMS | 2025-09-22 | Received in OIRA | Extension without change of a currently approved collection
Pre-Claim Review Demonstration For Home Health Services (CMS-10599)
Key Information
Abstract
The Centers for Medicare & Medicaid Services (CMS) is requesting the Office of Management and Budget (OMB) approval for the Pre-Claim Review Demonstration for Home Health Services. This demonstration would help assure that payments for home health services are appropriate before the claims are paid, thereby preventing fraud, waste, and abuse. CMS proposes performing prior authorization before processing claims for home health services in: Florida, Texas, Illinois, Michigan, and Massachusetts. |
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| 202509-1110-001 | Law Enforcement Officers Killed or Assaulted (LEOKA) | DOJ/FBI | 2025-09-22 | Received in OIRA | Extension without change of a currently approved collection
Law Enforcement Officers Killed or Assaulted (LEOKA)
Key Information
Abstract
Under Title 28, U.S.C., Sect. 534, this collection requests LEOKA data from local, state, tribal, and federal law enforcement agencies in order for the FBI UCR Program to serve as the national clearing house for collection and dissemination of data. |
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| 202509-3060-002 | Request for Audits and State Commissions' Access to Numbering Resource Application Information (47 C.F.R. Section 52.15) | FCC | 2025-09-22 | Active | Extension without change of a currently approved collection
Request for Audits and State Commissions' Access to Numbering Resource Application Information (47 C.F.R. Section 52.15)
Key Information
Abstract
The 2nd R&O imposed two paperwork related obligations on carriers, which were subsequently expanded to VoIP providers. 1. The NANPA, the Pooling Administrator, or a state commission may draft a request to the auditor stating the reason for the request, such as misleading or inaccurate data, and attach supporting documentation. 2. Requests for copies of providers' applications for numbering resources may be made directly to providers. The information collected will be used by the FCC, state commissions, the NANPA and the Pooling Administrator to verify the validity and accuracy of such data and to assist state commissions in carrying out their numbering responsibilities, such as area code relief. |
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| 202507-2126-002 | Financial Responsibility for Motor Carriers of Passengers and Motor Carriers of Property | DOT/FMCSA | 2025-09-22 | Received in OIRA | No material or nonsubstantive change to a currently approved collection
Financial Responsibility for Motor Carriers of Passengers and Motor Carriers of Property
Key Information
Abstract
This non-substantive change request is to update the expiration date for the forms MCS-82, MCS-82B, MCS-90, and MCS-90B. DOT promulgates regulations that establish minimum levels of financial responsibility for motor carriers of property to cover public liability, property damage, and environmental restoration, and minimum levels of financial responsibility for for-hire motor carriers of passengers to cover public liability and property damage. It is mandated that motor carriers maintain proof of the required financial responsibility at their principal places of business, available upon request of an FMCSA safety investigator during investigations or audits. Insurance endorsements and surety bonds are considered public information and must be produced by a motor carrier of property or a motor carrier of passengers for review upon reasonable request by a member of the public. Motor carriers domiciled in Canada, Mexico, and non-North America (NNA) domiciled carriers who transport property or conduct passenger transportation operations within the United States must obtain an insurance endorsement or surety bond. All vehicles operated in the United States by these motor carriers must have a legible copy of the insurance endorsement or surety bond in the vehicle available to Federal or State enforcement officials during roadside inspections. FMCSA and the public use the information collected to verify that a motor carrier of property or passengers has obtained, and has in effect, the required minimum levels of financial responsibility. This ICR has a program adjustment of an increase in annual responses and burden hours due to a 51 percent increase in the number of entities that registered in 2020-2022. The information collections (ICs) are as follows: IC1.1 - Property carriers to complete MCS-90 (insurance) IC1.2 - Property carriers to complete MCS-82 (surety) IC2.1 - Passenger carriers to complete MCS-90B (insurance) IC2.2 - Passenger carriers to complete MCS-82B (surety) IC1.3a - U.S. Property carriers to store MCS-90 (insurance) IC1.3b - U.S. Property carriers to store MCS-82 (surety) IC2.3a - U.S. Passenger carriers to store MCS-90B (insurance) IC2.3b - U.S. Passenger carriers to store MCS-82B (surety) IC1.3c - Mexico, NNA and Canada property carriers to store MCS-90 (insurance) IC1.3d - Mexico, NNA and Canada property carriers to store MCS-82 (surety) IC2.3c - Mexico, NNA and Canada passenger carriers to store MCS-90B (insurance) IC2.3d - Mexico, NNA and Canada passenger carriers to store MCS-82B (surety) |
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| 202507-2126-011 | Non-Insulin-Treated Diabetes Mellitus Assessment Form | DOT/FMCSA | 2025-09-22 | Received in OIRA | No material or nonsubstantive change to a currently approved collection
Non-Insulin-Treated Diabetes Mellitus Assessment Form
Key Information
Abstract
This is a non-substantive change request to update the form no. MCSA-5872, "Non-Insulin-Treated Diabetes Mellitus Assessment Form" with the correct expiration date. FMCSA seeks the Office of Management and Budget’s (OMB) approval of a new ICR titled, Non-Insulin-Treated Diabetes Mellitus Assessment Form, MCSA-5872. This ICR is voluntary and may be utilized by medical examiners (ME), who issue Medical Examiner’s Certificates, Form MCSA-5876, to individuals who operate commercial motor vehicles (CMV) in interstate commerce, to communicate with treating healthcare providers responsible for managing the individuals’ diagnosed non-insulin-treated diabetes mellitus. The purpose of the Non-Insulin-Treated Diabetes Mellitus Assessment Form, MCSA-5872, is to assist the ME in determining whether an individual diagnosed with non-insulin-treated diabetes mellitus is physically qualified and the individual’s physical condition is adequate to enable the individual to operate a CMV safely. Because this collection is voluntary, there is no set schedule for CMV operators or MEs to complete the form MCSA-5872. FMCSA estimates that MEs will request that forms be completed for 242,057 individuals with a corresponding number of treating healthcare providers. |
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