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

OMB 1652-0043

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 Law Enforcement/ Federal Air Marshal positions meet certain medical standards. The medical guidelines ensure a level of health status and physical and psychological fitness for this public safety law enforcement position which requires a high degree of responsibility. Medical guidelines are based on cognitive, physical, psychomotor, and psychological abilities related to the essential job functions of a FAM

The latest form for Law Enforcement/Federal Air Marshal Service (OLE/FAMS) Physical and Mental Health Certification expires 2023-07-31 and can be found here.

Latest Forms, Documents, and Supporting Material

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

OMB Details

Mental Health Certification

Federal Enterprise Architecture: Homeland Security - Border and Transportation Security

Form TSA Form 1164

Mental Health Certification

Fillable Fileable

Form and instruction

Review document collections for all forms, instructions, and supporting documents - including paper/printable forms.

202305-1652-002 Approved without change	Extension without change of a currently approved collection	2023-05-02
201906-1652-001 Approved without change	Revision of a currently approved collection	2019-07-31
201601-1652-004 Approved without change	Extension without change of a currently approved collection	2016-03-01
201210-1652-002 Approved without change	Extension without change of a currently approved collection	2012-12-31
201009-1652-001 Approved with change	Extension without change of a currently approved collection	2010-10-19
200708-1652-004 Approved without change	Revision of a currently approved collection	2007-08-29
200612-1652-002 Approved with change	New collection (Request for a new OMB Control Number)	2007-01-25