MCSA-5876 2015 free printable template
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Form MCSA-5876 (Revised: 12/06/2015) OMB No. 2126-0006 Expiration Date: 8/31/2018 Public Burden Statement A Federal agency may not conduct or sponsor, and a person is not required to respond to, nor
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How to fill out MCSA-5876
01
Start by downloading the MCSA-5876 form from the official website.
02
Read the instructions carefully before filling out the form.
03
Fill in your personal details, including your name, address, and contact information.
04
Provide relevant employment information, including your job title and employer details.
05
Indicate the purpose of filing the MCSA-5876 in the designated section.
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07
Review the completed form for accuracy and completeness.
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Sign and date the form to certify that the information provided is true.
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Submit the form as instructed, either online or via mail.
Who needs MCSA-5876?
01
Individuals applying for a Motor Carrier Authority certificate in the United States.
02
Businesses seeking to operate as a common carrier or a contract carrier.
03
Companies involved in transporting goods or passengers for hire.
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People Also Ask about
What is the full form of Mer in medical terms?
Medical Examination Report (MER) Form, MCSA-5875.
What are the requirements for a DOT physical in PA?
The DOT physical requires drivers to have 20/40 vision with or without the use of corrective lenses. This means you must be able to see at least 20/40 with both eyes, or at least 20/40 with either the right eye or left eye. Those with monovision may be disqualified from getting a DOT medical card.
What is OMB No 2126?
OMB 2126-0006. The revision to the ICR is due to the Agency's development of a final rule titled Qualifications of Drivers; Diabetes Standard to revise its regulations to eliminate the blanket prohibition against insulin-dependent diabetic individuals' operation of CMVs in interstate commerce.
What is a MCSA 5876 form?
If the Medical Examiner determines that the driver examined is physically qualified to drive a commercial motor vehicle in ance with the physical qualification standards, the Medical Examiner will complete and provide the driver with a Medical Examiner's Certificate (MEC), Form MCSA-5876.
What is a medical examiner's certificate via US Department of Transportation?
If the Medical Examiner determines that the driver examined is physically qualified to drive a commercial motor vehicle in ance with the physical qualification standards, the Medical Examiner will complete and provide the driver with a Medical Examiner's Certificate (MEC), Form MCSA-5876.
How long must a medical examiner retain a copy of the medical examination report for a qualified driver?
(i) Each original (paper or electronic) completed Medical Examination Report and a copy or electronic version of each medical examiner's certificate must be retained on file at the office of the medical examiner for at least 3 years from the date of examination.
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What is MCSA-5876?
MCSA-5876 is a form used by motor carriers to report their safety performance and compliance with safety regulations to the Federal Motor Carrier Safety Administration (FMCSA).
Who is required to file MCSA-5876?
Motor carriers that are involved in interstate commerce and are subject to FMCSA regulations are required to file MCSA-5876.
How to fill out MCSA-5876?
To fill out MCSA-5876, motor carriers must provide information related to their safety performance, including details about their fleet, safety management practices, and any incidents or violations that have occurred.
What is the purpose of MCSA-5876?
The purpose of MCSA-5876 is to collect data on the safety performance of motor carriers and to ensure compliance with federal safety regulations, ultimately enhancing road safety.
What information must be reported on MCSA-5876?
Information reported on MCSA-5876 includes details about the carrier's fleet size, safety policies, records of accidents, inspections, enforcement actions, and other safety-related information.
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