CCSF Application

Certified Cargo Screening Pilot Program

Documents and Forms

Document Name Document Type
Form TSA Form Number 41 CCSF Application Form and Instruction
TSA Form Number 41 CCSF Security Profile TSA Form 419E_CCSF Security Profile1.doc Form and Instruction
TSA Form Number 41 CCSF Principal Attestation TSA Form 419D_CCSF Principal Attestation.doc Form and Instruction
TSA Form Number 41 CCSF Facility Profile Application TSA Form 419B_CCSF Facility Profile Application.doc Form and Instruction

Information Collection (IC) Details

IC Title:	CCSF Application	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Electronic Capability
Form and Instruction	TSA Form Number 419E	CCSF Security Profile	TSA Form 419E_CCSF Security Profile1.doc	No	Fillable Printable
Form and Instruction	TSA Form Number 419D	CCSF Principal Attestation	TSA Form 419D_CCSF Principal Attestation.doc	No	Fillable Printable
Form and Instruction	TSA Form Number 419B	CCSF Facility Profile Application	TSA Form 419B_CCSF Facility Profile Application.doc	No	Fillable Printable

Line of Business: Homeland Security

Subfunction: Border and Transportation Security

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 2,000	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	2,000	2,000
Annual IC Time Burden (Hours)	4,000	4,000
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.