Dot Form Mcsa 5876 Printable Form MCSA 5876 M No Eiration Date 2 31 202 MEDICAL EXAMINER S CERTIFICATE for Commercial Driver Medical Certification Public 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
Form MCSA 5876 Revised 12 06 2015 OMB No 2126 0006 Expiration Date 8 31 2018 Public Burden Statement 2024 Understand the new DOT physical certification forms MCSA 5875 MCSA 5876 The DOT physical requirements haven t changed but
Dot Form Mcsa 5876 Printable
Dot Form Mcsa 5876 Printable
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FMCSA Form MCSA 5876 Form MCSA 5876 OMB No 2126 0006 Expiration Date 03 31 2025 Public 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 Permissible changes to the MEC Form MCSA 5876 1 The MEC Form MCSA 5876 can be reduced in size as long as all the content is readable 2 The MEC Form MCSA 5876 may be printed in black and white These are the only changes allowed
Form MCSA 5876 Revised 03 11 2013 OMB No 2126 0006 Expiration Date 07 31 2015 Medical Examiner s Certificate for Commercial Driver Medical Certification U S Department of Transportation Federal Motor Carrier A complete examination form with any attachment embodies my findings completely and correctly and is on file in my office Before you begin As a Commercial Driver s License CDL holder you are required to submit a medical report dated within the last two years every two years You are required to submit A valid original or copy federal MER MCSA 5875 form Medical Examiner s Certificate Form MEC MCSA 5876
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The Federal regulations also require commercial drivers to self certify the type of driving in which they operate or expect to operate Commercial drivers are required to certify using PennDOT s Self Certification Form DL 11CD PDF This webpage contains information and instructions to become compliant with these regulations Posted December 18 2021 New versions of the Medical Examiner s Certificate and Medical Examination Report Form have been released by FMCSA The new versions have an expiration date of 12 31 2024 in the upper right corner which was the only change to the forms
FMCSA Form MCSA 5876 Form MCSA 5876 OMB No 2126 0006 Expiration Date 11 30 2021 Please note the expiration date on this form relates to the process for renewing the Information Collection Request that includes this form with the Office of Management and Budget This requirement to collect information as requested on this form does not expire The expiration date on the Medical Examination Report Form MCSA 5875 Medical Examiner s Certificate MCSA 5876 and Insulin Treated Diabetes Mellitus Assessment Form MCSA 5870 has been updated to 12 31 2024 and all forms are posted below
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https://www.fmcsa.dot.gov/sites/fmcsa.dot.gov/files/2021-12/Medical%20Examiner%27s%20Certificate%2C%20Form%20MCSA-5876.pdf
Form MCSA 5876 M No Eiration Date 2 31 202 MEDICAL EXAMINER S CERTIFICATE for Commercial Driver Medical Certification Public 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
https://www.fmcsa.dot.gov/sites/fmcsa.dot.gov/files/docs/Medical-Examiners-Certificate-%28MEC%29-Form-MCSA-5876.pdf
Form MCSA 5876 Revised 12 06 2015 OMB No 2126 0006 Expiration Date 8 31 2018 Public Burden Statement
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Dot Form Mcsa 5876 Printable - Before you begin As a Commercial Driver s License CDL holder you are required to submit a medical report dated within the last two years every two years You are required to submit A valid original or copy federal MER MCSA 5875 form Medical Examiner s Certificate Form MEC MCSA 5876
