Information Collection

STA Applications

IC 189757 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 STA Applications	Form and Instruction
TSA Form Number 41 Security Threat Assessment Application TSA Form 419F_STA Application1.doc	Form and Instruction

IC Title:

STA Applications

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 49 CFR 1549.11

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	TSA Form Number 419F	Security Threat Assessment Application	TSA Form 419F_STA Application1.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: 1,500

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	82,500	82,500
Annual IC Time Burden (Hours)	20,625	20,625
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.