Treating Physician Status Report

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

OMB: 1652-0043

IC ID: 236329

Information Collection (IC) Details

View Information Collection (IC)

Treating Physician Status Report
 
No New
 
Mandatory
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction TSA Form 1163 Treating Physician Status Report TSA Form 1163, Treating Physician Status Report 6.26.2019.docx Yes Yes Fillable Fileable

Homeland Security Border and Transportation Security

Employee Medical File of Records of TSO   71 FR 35360

600 0
   
Individuals or Households
 
   0 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 600 0 0 600 0 0
Annual IC Time Burden (Hours) 150 0 0 150 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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