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⚠️ Notice: This information collection may be referencing outdated material.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 2211 SSI Access Threat Assessment Questionnaire Form and Instruction
TSA Form 2211 SSI Access Threat Assessment Questionnaire TSA Form 2211 FINAL 070116.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: Modified

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 2211	SSI Access Threat Assessment Questionnaire	TSA Form 2211 FINAL 070116.pdf		No		Printable Only

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: 180	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	Previously Approved
Annual Number of Responses for this IC	180	100	80
Annual IC Time Burden (Hours)	180	100	80
Annual IC Cost Burden (Dollars)	0	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.