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Medical Examiner's Certificate - Federal Motor Carrier ...

Form MCSA-5876 (Revised: 12/06/2015)OMB No. 2126-0006 Expiration Date: 8/31/2018 Medical Examiner's Certificate (for Commercial Driver Medical Certification) Department of Transportation Federal Motor Carrier safety AdministrationPublic Burden Statement A Federal agency may not conduct or sponsor, and a person is not required to respond to, nor shall a person be subject to a penalty for failure to comply with a collection of information subject to the requirements of the Paperwork Reduction Act unless that collection of information displays a current valid OMB Control Number.

Dec 06, 2015 · (Revised: 12/06/2015) OMB No. 2126-0006. Expiration Date: 8/31/2018. Medical Examiner's Certificate (for Commercial Driver Medical Certification) U.S. Department of Transportation Federal Motor Carrier Safety Administration. Public Burden Statement

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