Information Collection

CCSF Application

IC 189749 under ICR 200908-1652-002 · OMB 1652-0052.

Documents and Forms

Documents and forms in this information collection
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

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:

table that charts list of 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 %

table that charts list of burden
	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

table that charts IC Documents
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.