Information Collection

CCSF Applications

IC 189821 under ICR 201204-1652-004 · 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⚠️ Notice: This information collection may be referencing outdated material.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 419B CCSF Applications	Form and Instruction
TSA Form 419B CCSF Facility Profile Application TSA_Form_419B_CCSF_Facility_Profile_Application.doc	Form and Instruction
TSA Form 419E CCSF Security Profile TSA_Form_419E_CCSF_Security_Profile.doc	Form and Instruction
TSA Form 419D CCSF Principal Attestation TSA_Form_419D_CCSF_Principal_Attestation.doc	Form and Instruction

IC Title:

CCSF Applications

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 49 CFR 1549.7

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	TSA Form 419B	CCSF Facility Profile Application	TSA_Form_419B_CCSF_Facility_Profile_Application.doc	Yes	Yes	Fillable Fileable
Form and Instruction	TSA Form 419E	CCSF Security Profile	TSA_Form_419E_CCSF_Security_Profile.doc	Yes	Yes	Fillable Fileable
Form and Instruction	TSA Form 419D	CCSF Principal Attestation	TSA_Form_419D_CCSF_Principal_Attestation.doc	Yes	Yes	Fillable Fileable

Line of Business: Homeland Security

Subfunction: Border and Transportation Security

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 967

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	967	-6,547	7,514
Annual IC Time Burden (Hours)	1,934	-13,094	15,028
Annual IC Cost Burden (Dollars)	0	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.