Office of Law Enforcement/Federal Air Marshal Service (OLE/FAMS) Mental Health Certification

ICR 200708-1652-004

OMB: 1652-0043

Federal Form Document

Forms and Documents
Document
Name
Status
Form and Instruction
Modified
Supporting Statement A
2007-08-29
Supplementary Document
2007-08-29
Supplementary Document
2007-08-29
Supplementary Document
2007-08-29
IC Document Collections
IC ID
Document
Title
Status
46519 Modified
ICR Details
1652-0043 200708-1652-004
Historical Active 200612-1652-002
DHS/TSA
Office of Law Enforcement/Federal Air Marshal Service (OLE/FAMS) Mental Health Certification
Revision of a currently approved collection   No
Regular
Approved without change 10/10/2007
Retrieve Notice of Action (NOA) 08/29/2007
  Inventory as of this Action Requested Previously Approved
10/31/2010 36 Months From Approved 10/31/2007
10,000 0 10,000
10,000 0 10,000
4,100 0 3,900

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 Office of Law Enforcement/ Federal Air Marshal positions meet certain medical standards, which includes a psychological evaluation. Applicants will be required to complete a certification regarding their mental health history and provide an explanation for anything they cannot certify. This certification is carefully geared to capitalize on other elements of the assessment process, such as personal interviews, physical task assessment, background investigation, as well as the other components of the medical examination and assessment.

US Code: 49 USC 44917 Name of Law: ATSA
   US Code: 49 USC 44901 Name of Law: ATSA
   US Code: 49 USC 44903 Name of Law: ATSA
  
None

Not associated with rulemaking

  72 FR 34032 06/20/2007
72 FR 48660 08/24/2007
No

1
IC Title Form No. Form Name
FAMS Mental Health Certification TSA FORM 1164 Mental Health Certification

  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 10,000 10,000 0 0 0 0
Annual Time Burden (Hours) 10,000 10,000 0 0 0 0
Annual Cost Burden (Dollars) 4,100 3,900 0 0 200 0
No
No

$67,250
No
No
Uncollected
Uncollected
Uncollected
Uncollected
Joanna Johnson 571-227-3651 [email protected]

  No

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
08/29/2007


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