Law Enforcement/Federal Air Marshal Service (OLE/FAMS) Physical and Mental Health Certification

ICR 202305-1652-002

OMB: 1652-0043

Federal Form Document

Forms and Documents

Document Name	Status
Form TSA Form 1164 Mental Health Certification Form and Instruction	Modified
Form TSA Form 1163 Applicants' Time Waiting as Healthcare Provider Completes Forms Form and Instruction	New
Form TSA Form 1163 Applicants Travel Time Form and Instruction	New
Form TSA Form 1163 Treating Physician Status Report Form and Instruction	Modified
Form TSA Form 1133-3 Practical Exercise Performance Requirements (PEPR) form Form and Instruction	Modified
privacy-pia-dhs-all043-hiring and onboarding-april2017.pdf Supplementary Document	2019-06-04
opm-sorn-govt-5-recruiting-examining-and-placement-records.pdf Supplementary Document	2019-06-04
1652-0043 LEFAMS PMHC 30DN_88 FR 27525 (5.2.2023).pdf Supplementary Document	2023-05-02
1652-0043 LEFAMS PMHC 60DN 83 FR 62878 (12.6.2018).pdf Supplementary Document	2019-06-03
1652-0043 LEFAMS PMHC SS 5.2.2023.docx Supporting Statement A	2023-05-02
DHS-TSA 001.pdf Supplementary Document	2010-09-24
OPM-GOVT-10%20-%20Medical%20Records[1].pdf Supplementary Document	2010-09-24
49 USC 44917[1].doc Supplementary Document	2007-08-29
49 USC 44903[1].doc Supplementary Document	2007-08-29
49 USC 44901[1].doc Supplementary Document	2007-08-29

IC Document Collections

IC ID	Document Title	Status
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