Special Agent Medical (Preplacement/Incumbent)

OMB 1140-0056

OMB 1140-0056

The Special Agent Medical (Preplacement/Incumbent) Form - ATF Form 2300.10 is used to collect specific personally identifiable information (PII), including the name, address, telephone, social security number and certain medical data. The collected medical data is used to determine if a candidate is medically qualified for and can be hired to serve as a criminal investigator (special agent) or an explosives enforcement officer.

The latest form for Special Agent Medical (Preplacement/Incumbent) expires 2023-07-31 and can be found here.


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