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OMB Control No: 1652-0043	ICR Reference No: 201906-1652-001
Status: Historical Active	Previous ICR Reference No: 201601-1652-004
Agency/Subagency: DHS/TSA	Agency Tracking No:
Title: Law Enforcement/Federal Air Marshal Service (OLE/FAMS) Physical and Mental Health Certification
Type of Information Collection: Revision of a currently approved collection	Common Form ICR: No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 07/14/2020
	Date Received in OIRA: 07/31/2019
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	07/31/2023	36 Months From Approved	07/31/2020
Responses	1,800	0	600
Time Burden (Hours)	900	0	600
Cost Burden (Dollars)	0	0	0

Abstract: 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

Authorizing Statute(s): US Code: 49 USC 44903 Name of Law: ATSA
   US Code: 49 USC 44917 Name of Law: ATSA
   US Code: 49 USC 44901 Name of Law: ATSA

Citations for New Statutory Requirements: None

Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	83 FR 62878	12/06/2018
30-day Notice:	Federal Register Citation:	Citation Date:
	84 FR 23602	05/21/2019
Did the Agency receive public comments on this ICR? Yes

Number of Information Collection (IC) in this ICR: 3

IC Title	Form No.	Form Name
Mental Health Certification	TSA Form 1164
Practical Exercise Performance Requirements (PEPR) form	TSA Form 1133-3
Treating Physician Status Report	TSA Form 1163

ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to Adjustment in Estimate
Annual Number of Responses	1,800	600	1,200
Annual Time Burden (Hours)	900	600	300
Annual Cost Burden (Dollars)	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: Although there are no changes to the information being collected, as noted in the response to Item 2, the collection is being revised to include the following additional forms: (1) TSA Form 1163, Treating Physician Status Report (TPSR), and (2) TSA Form 1133-1, Practical Exercise Performance Requirements (PEPR), to assist in the determination and in conjunction with further evaluation requests as needed for applicants of a FAMs position or incumbent FAMs. Additionally, TSA is revising the name of the collection from “Office of Law Enforcement/Federal Air Marshal Service Mental Health Certification” to “Law Enforcement/Federal Air Marshal Service Physical and Mental Health Certification.” Finally, TSA is also revising the collection process to allow other authorized healthcare providers to certify the applicant’s or incumbent FAM’s medical status, when applicable. TSA has modified the PEPR form and the TPSR form to accept paperwork signed by an APRN in non-complex cases. TSA expects the modification of the forms will ease the burden of compliance by expanding the field of individuals, physician or APRN, who can be consulted to comply with the regulatory requirements. TSA will submit this collection as a Deregulatory Action. In Item 13, the change noted includes the removal of costs associated with mailing the documents. TSA revised the estimated cost to the Federal Government reported in Item 14 based on an update to the TSA wage rate and the number of respondents.

Annual Cost to Federal Government: $3,175

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination. Yes

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination. Yes

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? No

Agency Contact: Christina Walsh 571 227-2062 christina.walsh@tsa.dhs.gov

View ICR - OIRA Conclusion