Applicants' Time Waiting as Healthcare Provider Completes Forms

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

Documents and Forms

Document Name Document Type
Form TSA Form 1163 Applicants' Time Waiting as Healthcare Provider Completes Forms Form and Instruction
TSA Form 1163 Treating Physician Status Report TSA Form 1163, Treating Physician Status Report.pdf Form and Instruction
TSA Form 1163 Treating Physician Status Report TSA Form 1163, Treating Physician Status Report.pdf Form and Instruction
TSA Form 1133-3 Practical Exercise Performance Requirements TSA Form 1133-3, Practical Exercise Performance Requirements.pdf Form and Instruction
TSA Form 1133-3 Practical Exercise Performance Requirements TSA Form 1133-3, Practical Exercise Performance Requirements.pdf Form and Instruction

Information Collection (IC) Details

IC Title:	Applicants' Time Waiting as Healthcare Provider Completes Forms	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

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.pdf		Yes	Yes	Fillable Fileable Signable
Form and Instruction	TSA Form 1133-3	Practical Exercise Performance Requirements	TSA Form 1133-3, Practical Exercise Performance Requirements.pdf		Yes	Yes	Fillable Fileable Signable

Line of Business: Homeland Security

Subfunction: Border and Transportation Security

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 50	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Change Due to Adjustment in Agency Estimate
Annual Number of Responses for this IC	50	50
Annual IC Time Burden (Hours)	25	25
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.