Information Collection Request
Transportation Security Officer Medical Questionnaire
ICR 202305-1652-001 · OMB 1652-0032 · Received in OIRA
⚠️ Notice: This information collection may be outdated. More recent filings for OMB 1652-0032 can be found here:
Forms and Documents
| Document | Type | Status | Availability |
|---|---|---|---|
 Form TSA Form 1130A-1 TSO Medical Questionnaire and Evaluation; Travel |
Form and Instruction | Modified | Missing upstream |
 OPMGOVT-5.pdf |
Supplementary Document | Uploaded 2016-05-04 | Repair queued |
| OPMGOVT-10 System.pdf |
Supplementary Document | Uploaded 2016-05-04 | Repair queued |
| SORN DHSTSA - 022 71 FR 40530 (7172006).pdf |
Supplementary Document | Uploaded 2016-05-04 | Missing upstream |
| 1652-0032 TranspSOMQ 30DN 88 FR 27524 (5.2.2023).pdf |
Supplementary Document | Uploaded 2023-05-02 | Missing upstream |
| 1652-0032 TranspSOMQ 60DN 88 FR 5903 (1.30.2023).pdf |
Supplementary Document | Uploaded 2023-05-01 | Missing upstream |
 1652-0032 TranspSOMQ SS 5.2.2023.docx |
Supporting Statement A | Uploaded 2023-05-02 | Repair queued |
| privacy_pia_tsa_hraccess[1].pdf |
Supplementary Document | Uploaded 2010-01-15 | Repair queued |
 44 USC 44935.doc |
Supplementary Document | Uploaded 2006-09-15 | Repair queued |
IC Document Collections
| IC ID | Collection | Type | Status | Form |
|---|---|---|---|---|
| 191700 |  TSO Medical Questionnaire and Evaluation; Travel |
Form and Instruction | Modified |
ICR Details
| Status | Received in OIRA |
|---|---|
| Agency/Subagency | DHS/TSA |
| OMB Control No | 1652-0032 |
| Type of Information Collection | Extension without change of a currently approved collection |
| Previous ICR Reference No | 201904-1652-001 |
| Date Submitted to OIRA | 1969-12-31 |
| Requested Expiration Date | 1969-12-31 |