SSI Access Threat Assessment Questionnaire

Sensitive Security Information Threat Assesment Application

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1652-0042 can be found here:

Documents and Forms

Document Name Document Type
Form TSA Form 2211 SSI Access Threat Assessment Questionnaire Form
TSA Form 2211 SSI Access Threat Assessment Questionaire TSA Form 2211 2013.doc Form

Information Collection (IC) Details

IC Title:	SSI Access Threat Assessment Questionnaire	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation: 49 CFR 1520

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	TSA Form 2211	SSI Access Threat Assessment Questionaire	TSA Form 2211 2013.doc		Yes	No	Printable Only

Line of Business: Homeland Security

Subfunction: Border and Transportation Security

Privacy Act System of Records
Title: Transportation Threat Assessment System	FR Citation: 70 FR 67731

Number of Respondents: 127	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	127	-53	180
Annual IC Time Burden (Hours)	343	-143	486
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.