About this document

This document is the Federal hearing exemption renewal application used by individuals renewing their Federal hearing exemption. All requested information must be submitted to the Federal Motor Carrier Safety Administration (FMCSA) for consideration.

U.S. Department of Transportation
Federal Motor Carrier Safety Administration

THE FEDERAL HEARING EXEMPTION RENEWAL PROCESS

Dear Renewal Applicant:

If you have been issued a Federal exemption from the hearing standard under 49 CFR 391.41(b)(11) and you would like to renew it, you must submit the following information no sooner than 3 months, but no later than 1 month prior to the date your current exemption expires. If the information is not submitted in the specified timeframe, there is a chance that you will have a lapse in your ability to operate a commercial motor vehicle in interstate commerce. FMCSA must have adequate time to review and process your renewal request.

Please submit the following information:

1.    A written request to renew your hearing exemption.

2.    A legible copy of your driver’s license, front and back.

3.    Completed and signed Authorization for Release of Medical Information Form.
a.    This form is available on FMCSA’s website at: https://www.fmcsa.dot.gov/medical/driver-medical-requirements/medical-release-info-12-2006 
b.    A sample of a completed form is available on FMCSA’s website at: https://www.fmcsa.dot.gov/medical/driver-medical-requirements/medical-release-info-hearing-sample 

4.    A legible copy of your driving record for the last 3 years. If you were involved in any crash or were convicted for any moving violation, provide additional official documentation (e.g., a copy of the crash report or the citation).

NOTE: The driving record must be dated within 3 months of the date of your application.

5.    A legible copy of your Medical Examiner’s Certificate, MCSA-5876 indicating that a hearing exemption is required.

 
Your information may be e-mailed, mailed or faxed (PLEASE DO NOT DO MORE THAN ONE).

E-mail to:

FMCSAhearingexemptions@dot.gov 

Mail to:

Federal Motor Carrier Safety Administration
Hearing Exemption Program, W64-224
1200 New Jersey Avenue, SE 
Washington, DC  20590

Fax to:

(877) 764-6920 and title the document, “ATTENTION RENEWAL HEARING EXEMPTIONS”

If you do not wish to renew your Federal hearing exemption, please notify FMCSA in writing.

If you have any questions, contact FMCSA’s Hearing Exemption Program at FMCSAhearingexemptions@dot.gov. 

Sincerely,

FMCSA’s Medical Programs Division