OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

Office of Law Enforcement/Federal Air Marshal Service (OLE/FAMS) Mental Health Certification

ICR 200612-1652-002 · OMB 1652-0043 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
Form TSA form 1164 FAMS Mental Health Certification Form and Instruction New Available
FAMS Mental Health Cert 30DY (12-5-06).pdf Supplementary Document Uploaded 2007-01-25 Repair queued
FAMS.emer req memo.pdf Supplementary Document Uploaded 2006-12-21 Available
49 USC 44917.doc Supplementary Document Uploaded 2006-12-21 Repair queued
49 USC 44903.doc Supplementary Document Uploaded 2006-12-21 Available
49 USC 44901.doc Supplementary Document Uploaded 2006-12-21 Repair queued
FAMS.Supp Stmt.pdf Supporting Statement A Uploaded 2006-12-21 Available
IC Document Collections
IC IDCollectionTypeStatusForm
46519 FAMS Mental Health Certification Form and Instruction New
ICR Details
1652-0043 200612-1652-002
Historical Active
DHS/TSA
Office of Law Enforcement/Federal Air Marshal Service (OLE/FAMS) Mental Health Certification
New collection (Request for a new OMB Control Number)   No
Emergency 02/14/2007
Approved with change 02/08/2007
Retrieve Notice of Action (NOA) 01/25/2007
  Inventory as of this Action Requested Previously Approved
08/31/2007 6 Months From Approved
10,000 0 0
10,000 0 0
3,900 0 0
In furtherance of TSA’s authority to provide for deployment of Federal Air Marshals (FAMs) on passenger flights, and provide for appropriate training, supervision, and equipment of FAMs TSA policy requires that applicants for Office of Law Enforcement/ Federal Air Marshal positions meet certain medical standards, which includes a psychological evaluation. Applicants will be required to complete a certification regarding their mental health history and provide an explanation for anything they cannot certify. This certification is carefully geared to capitalize on other elements of the assessment process, such as personal interviews, physical task assessment, background investigation, as well as the other components of the medical examination and assessment.
In accordance with new Transportation Security Administration (TSA) Office of Law Enforcement/Federal Air Marshal Service hiring requirements, TSA requests immediate approval to collect this information via a Mental Health Certification from Federal Air Marshal applicants. In order to adequately protect the flying public, TSA must determine an applicant’s medical eligibility and conclude that there is no established medical history or diagnosis of personality disorders that clearly demonstrate a potential hazard to the performance of the Federal Air Marshal duties or the safety of self or others. Standard clearance procedures will prevent the immediate collection of necessary medical information, which will adversely affect the hiring of new Federal Air Marshals and encumber their operational deployment.
US Code: 49 USC 44917 Name of Law: ATSA
   US Code: 49 USC 44901 Name of Law: ATSA
   US Code: 49 USC 44903 Name of Law: ATSA
  
None
Not associated with rulemaking
71 FR 70524 12/05/2006
No
1
IC Title Form No. Form Name
FAMS Mental Health Certification TSA form 1164 Mental Health Certification
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 10,000 0 0 10,000 0 0
Annual Time Burden (Hours) 10,000 0 0 10,000 0 0
Annual Cost Burden (Dollars) 3,900 0 0 3,900 0 0
Yes
Miscellaneous Actions
No
The burden increase is due to the fact that this is a new collection.
$67,250
No
No
Uncollected
Uncollected
Uncollected
Uncollected
Katrina Wawer 571 227-1995 [email protected]
  No
On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
01/25/2007