Information Collection

STA Applications

IC 189823 under ICR 201101-1652-003 · OMB 1652-0053.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1652-0053 can be found here:

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_Application.doc	Form and Instruction

IC Title:

STA Applications

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Unchanged

Obligation to Respond: Mandatory

CFR Citation: 49 CFR 1549.103 49 CFR 1522.117 49 CFR 1522.121 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_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: 313,164

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	Previously Approved
Annual Number of Responses for this IC	313,164	313,164
Annual IC Time Burden (Hours)	78,291	78,291
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.