OMB control number
Special Agent Medical (Preplacement/Incumbent)
OMB 1140-0056 ยท DOJ/ATF.
OMB 1140-0056
The Special Agent Medical (Preplacement/Incumbent) Form - ATF Form 2300.10 is used to collect specific personally identifiable information (PII), including the name, address, telephone, social security number and certain medical data. The collected medical data is used to determine if a candidate is medically qualified for and can be hired to serve as a criminal investigator (special agent) or an explosives enforcement officer.
The latest form for Special Agent Medical (Preplacement/Incumbent) expires 2026-10-31 and is listed under ICR 202306-1140-007.
Latest Forms, Documents, and Supporting Material
| Document | Type |
|---|---|
 Form ATF F 2300.10 Special Agent Medical (Preplacement/Incumbent) | Form and Instruction |
| 5 CFR 339.301 Authority to Require an Examination 1.1.2019.pdf | Supplementary Document |
 1140-0056 Supporting Statement A (2023).docx | Supporting Statement A |
 Special Agent Medical (Preplacement/Incumbent) |
Form and Instruction |
All Historical Document Collections
| Reference | Filing | Received | Concluded | Action |
|---|---|---|---|---|
| 202306-1140-007 | Revision of a currently approved collection | 2023-07-31 | Approved without change | |
| 202004-1140-005 | Revision of a currently approved collection | 2020-04-23 | Approved without change | |
| 201702-1140-002 | Revision of a currently approved collection | 2017-02-24 | Approved without change | |
| 201312-1140-001 | Reinstatement with change of a previously approved collection | 2013-12-03 | Approved without change | |
| 201009-1140-003 | Extension without change of a currently approved collection | 2010-09-22 | Approved without change | |
| 200706-1140-004 | Extension without change of a currently approved collection | 2007-07-12 | Approved without change | |
| 200405-1140-004 | Extension without change of a currently approved collection | 2004-05-28 | Approved without change | |
| 200301-1140-070 | New collection (Request for a new OMB Control Number) | 2003-01-24 | Approved without change |