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⚠️ Notice: This information collection may be referencing outdated material.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

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

Information Collection (IC) Details

View Information Collection (IC)

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:

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 %

	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

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.