Information Collection Request
Law Enforcement/Federal Air Marshal Service (OLE/FAMS) Physical and Mental Health Certification
ICR 202305-1652-002 · OMB 1652-0043 · Received in OIRA
Forms and Documents
| Document | Type | Status | Availability |
|---|---|---|---|
 Form TSA Form 1164 Mental Health Certification |
Form and Instruction | Modified | Missing upstream |
| Form TSA Form 1163 Applicants' Time Waiting as Healthcare Provider Completes Forms |
Form and Instruction | New | Repair queued |
| Form TSA Form 1163 Applicants Travel Time |
Form and Instruction | New | Missing upstream |
| Form TSA Form 1163 Treating Physician Status Report |
Form and Instruction | Modified | Repair queued |
| Form TSA Form 1133-3 Practical Exercise Performance Requirements (PEPR) form |
Form and Instruction | Modified | Repair queued |
 privacy-pia-dhs-all043-hiring and onboarding-april2017.pdf |
Supplementary Document | Uploaded 2019-06-04 | Missing upstream |
| opm-sorn-govt-5-recruiting-examining-and-placement-records.pdf |
Supplementary Document | Uploaded 2019-06-04 | Repair queued |
| 1652-0043 LEFAMS PMHC 30DN_88 FR 27525 (5.2.2023).pdf |
Supplementary Document | Uploaded 2023-05-02 | Repair queued |
| 1652-0043 LEFAMS PMHC 60DN 83 FR 62878 (12.6.2018).pdf |
Supplementary Document | Uploaded 2019-06-03 | Missing upstream |
 1652-0043 LEFAMS PMHC SS 5.2.2023.docx |
Supporting Statement A | Uploaded 2023-05-02 | Missing upstream |
| DHS-TSA 001.pdf |
Supplementary Document | Uploaded 2010-09-24 | Missing upstream |
| OPM-GOVT-10%20-%20Medical%20Records[1].pdf |
Supplementary Document | Uploaded 2010-09-24 | Repair queued |
 49 USC 44917[1].doc |
Supplementary Document | Uploaded 2007-08-29 | Available |
| 49 USC 44903[1].doc |
Supplementary Document | Uploaded 2007-08-29 | Available |
| 49 USC 44901[1].doc |
Supplementary Document | Uploaded 2007-08-29 | Repair queued |
IC Document Collections
| IC ID | Collection | Type | Status | Form |
|---|---|---|---|---|
| 46519 |  Mental Health Certification |
Form and Instruction | Modified | |
| 259987 | Applicants' Time Waiting as Healthcare Provider Completes Forms |
Form and Instruction | New | |
| 259986 | Applicants Travel Time |
Form and Instruction | New | |
| 236329 | Treating Physician Status Report |
Form and Instruction | Modified | |
| 236328 | Practical Exercise Performance Requirements (PEPR) form |
Form and Instruction | Modified |
ICR Details
| Status | Received in OIRA |
|---|---|
| Agency/Subagency | DHS/TSA |
| OMB Control No | 1652-0043 |
| Type of Information Collection | Extension without change of a currently approved collection |
| Previous ICR Reference No | 201906-1652-001 |
| Date Submitted to OIRA | 1969-12-31 |
| Requested Expiration Date | 1969-12-31 |