SSI Access Threat Assessment Questionnaire

Sensitive Security Information Threat Assesment Application

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1652-0042 can be found here:

Documents and Forms

Document Name Document Type
Form TSA form number 22 SSI Access Threat Assessment Questionnaire Form and Instruction
TSA form number 22 SSI Access Threat Assessment Questionnaire SSI Access Threat Assessmt Q.pdf Form and Instruction

Information Collection (IC) Details

IC Title:	SSI Access Threat Assessment Questionnaire	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Voluntary

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 number 2211	SSI Access Threat Assessment Questionnaire	SSI Access Threat Assessmt Q.pdf		Yes	No	Fillable Printable

Line of Business: Homeland Security

Subfunction: Border and Transportation Security

Privacy Act System of Records
Title: Transportation Threat Assessment System	FR Citation: 70 FR 67731

Number of Respondents: 80	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	80	80
Annual IC Time Burden (Hours)	80	80
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.