Information Collection Request

Transportation Security Officer Medical Questionnaire

ICR 202609-1652-001 · OMB 1652-0032 · Received in OIRA

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form TSA Form 1137-1 TRANSPORTATION SECURITY OFFICER MEDICAL CLEARANCE Form and Instruction Modified Available
1652-0032 TranspSOMQ_omb-83-c.pdf Justification for No Material/Nonsubstantive Change Uploaded 2026-09-09 Available
1652-0032 TransspSOMQ Emergency ICR memo.pdf Supplementary Document Uploaded 2026-06-09 Available
OPMGOVT-5.pdf Supplementary Document Uploaded 2016-05-04 Available
OPMGOVT-10 System.pdf Supplementary Document Uploaded 2016-05-04 Available
SORN DHSTSA - 022 71 FR 40530 (7172006).pdf Supplementary Document Uploaded 2016-05-04 Available
1652-0032 TranspSOMQ 30DN 88 FR 27524 (5.2.2023).pdf Supplementary Document Uploaded 2023-05-02 Available
1652-0032 TranspSOMQ 60DN 88 FR 5903 (1.30.2023).pdf Supplementary Document Uploaded 2023-05-01 Available
1652-0032 TranspSOMQ SS_9.9.2026.docx Supporting Statement A Uploaded 2026-09-14 Available
privacy_pia_tsa_hraccess[1].pdf Supplementary Document Uploaded 2010-01-15 Available
44 USC 44935.doc Supplementary Document Uploaded 2006-09-15 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
280827 TSO Medical Clearance Form Form and Instruction ModifiedTRANSPORTATION SECURITY OFFICER MEDICAL CLEARANCE
191700 Online TSO Medical Questionnaire Other-Screenshots Unchanged

ICR Details

Reginfo record details
table that charts list comparision
  Requested Previously Approved
12/31/2026 12/31/2026
36,000 36,000
43,200 43,200
3,486,680 3,486,680





Reginfo record details
2
table that charts list of burden
IC Title Form No. Form Name
Online TSO Medical Questionnaire
TSO Medical Clearance Form TSA Form 1137-1

table that charts list of burden
  Total Request 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 36,000 36,000 0 0 0 0
Annual Time Burden (Hours) 43,200 43,200 0 0 0 0
Annual Cost Burden (Dollars) 3,486,680 3,486,680 0 0 0 0


Reginfo record details
  No