Respiratory FE form

Transportation Security Officer Medical Questionnaire

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1652-0032 can be found here:

Documents and Forms

Document Name Document Type
Respiratory FE form Form and Instruction
Respiratory further evaluation FE Form Respiratory 2006-0726.pdf Form and Instruction

Information Collection (IC) Details

IC Title:	Respiratory FE form	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	n/a	Respiratory further evaluation	FE Form Respiratory 2006-0726.pdf		No		Paper Only

Line of Business: Transportation

Subfunction: Air Transportation

Privacy Act System of Records
Title: OPM/GOVT-10, OPM/GOVT-5	FR Citation: 65 FR 24750

Number of Respondents: 1,602	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	1,602	1,602
Annual IC Time Burden (Hours)	534	534
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.