OMB.report

Federal forms, ICRs, and supporting documents

OMB control number

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

OMB 1652-0043 · DHS/TSA.

OMB 1652-0043

In furtherance of TSA's authority to provide for deployment of Federal Air Marshals (FAMs) on passenger flights, and provide for appropriate training, supervision, and equipment of FAMs TSA policy requires that applicants for Law Enforcement/ Federal Air Marshal positions meet certain medical standards. The medical guidelines ensure a level of health status and physical and psychological fitness for this public safety law enforcement position which requires a high degree of responsibility. Medical guidelines are based on cognitive, physical, psychomotor, and psychological abilities related to the essential job functions of a FAM

The latest form for Law Enforcement/Federal Air Marshal Service (OLE/FAMS) Physical and Mental Health Certification expires 2026-10-31 and is listed under ICR 202305-1652-002.

Latest Forms, Documents, and Supporting Material

Latest forms, documents, and information collections
DocumentType
Form TSA Form 1164 Mental Health CertificationForm and Instruction
Form TSA Form 1163 Applicants' Time Waiting as Healthcare Provider Completes FormsForm and Instruction
Form TSA Form 1163 Applicants Travel TimeForm and Instruction
Form TSA Form 1163 Treating Physician Status ReportForm and Instruction
Form TSA Form 1133-3 Practical Exercise Performance Requirements (PEPR) formForm and Instruction
privacy-pia-dhs-all043-hiring and onboarding-april2017.pdf Supplementary Document
opm-sorn-govt-5-recruiting-examining-and-placement-records.pdf Supplementary Document
1652-0043 LEFAMS PMHC 30DN_88 FR 27525 (5.2.2023).pdf Supplementary Document
1652-0043 LEFAMS PMHC 60DN 83 FR 62878 (12.6.2018).pdf Supplementary Document
1652-0043 LEFAMS PMHC SS 5.2.2023.docxSupporting Statement A
DHS-TSA 001.pdf Supplementary Document
OPM-GOVT-10%20-%20Medical%20Records[1].pdf Supplementary Document
49 USC 44917[1].doc Supplementary Document
49 USC 44903[1].doc Supplementary Document
49 USC 44901[1].doc Supplementary Document
Mental Health Certification Form and Instruction
Applicants' Time Waiting as Healthcare Provider Completes Forms Form and Instruction
Applicants Travel Time Form and Instruction
Treating Physician Status Report Form and Instruction
Practical Exercise Performance Requirements (PEPR) form Form and Instruction

All Historical Document Collections

Historical document collections
ReferenceFilingReceivedConcludedAction
202305-1652-002 Extension without change of a currently approved collection 2023-05-02 Approved without change
201906-1652-001 Revision of a currently approved collection 2019-07-31 Approved without change
201601-1652-004 Extension without change of a currently approved collection 2016-03-01 Approved without change
201210-1652-002 Extension without change of a currently approved collection 2012-12-31 Approved without change
201009-1652-001 Extension without change of a currently approved collection 2010-10-19 Approved with change
200708-1652-004 Revision of a currently approved collection 2007-08-29 Approved without change
200612-1652-002 New collection (Request for a new OMB Control Number) 2007-01-25 Approved with change

OMB Details

Mental Health Certification

Federal Enterprise Architecture: Homeland Security - Border and Transportation Security

Information collection instruments
FormNameElectronic accessType
Form TSA Form 1164Mental Health CertificationFillable FileableForm and instruction

Review document collections for all forms, instructions, and supporting documents - including paper/printable forms.