Form Mcsa-5871 - Department of transportation federal motor carrier safety administration. 2 (complete page 2) 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 Members can find the form at 3 different locations on the teamcme website. This form can be used as part of a certified medical examiner examination. Find the pdf form, the final rule, and the deadline for submission. The evaluation can be completed at the licensed provider of the driver’s choosing and is valid for 45 days. A vision evaluation report will need some basic identifying information such as the driver’s name, date of birth, driver’s license number, and state. This form will determine a driver’s qualification for the exemption.
This form will determine a driver’s qualification for the exemption. 2 (complete page 2) 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 This form can be used as part of a certified medical examiner examination. Find the pdf form, the final rule, and the deadline for submission. A vision evaluation report will need some basic identifying information such as the driver’s name, date of birth, driver’s license number, and state. The evaluation can be completed at the licensed provider of the driver’s choosing and is valid for 45 days. Department of transportation federal motor carrier safety administration. Members can find the form at 3 different locations on the teamcme website.