Form TSA Form 424 TSA Form 424 Screening Partnership Program Application

OMB Control Number 1652-NEW;

Exp. XX/XX/XXX

DEPARTMENT OF HOMELAND SECURITY

Transportation Security Administration

SCREENING PARTNERSHIP PROGRAM APPLICATION

INSTRUCTIONS: Complete a separate application for each individual airport location. An authorized representative of the airport or the airport owner must complete the application. The application must be completed in full to be considered for approval by TSA. Attach all supporting documentation to the application and use separate sheets if more detail is needed. Please provide a copy of the completed application to the Federal Security Director.
SECTION I. Airport Information
Request Date      	Airport Name      	FAA Identifier      
Airport Operating Authority      
SECTION II. Contact Information
Authorized Requestor      		Position      
Primary Number      	Alternate Phone Number      	Email Address      
Mailing Address      		Email Address      
SECTION III. Required Information
Indicate if the requesting airport authority seeks to provide or may seek to provide the private security screening services at the airport. Airports interested in providing their own private security screening services must submit a proposal (per instructions posted on FedBizOpps.gov) and compete for contract award in accordance with the Competition in Contracting Act and the Federal Acquisition Regulation. a. YES b. NO Per 49 U.S.C.44920 as amended by the FAA Modernization and Reform Act of 2012 (P.L. 112-95), the airport authority shall provide a recommendation as to which company would best serve the security screening and passenger needs of the airport, along with a statement explaining the basis of the airport operator’s recommendation. NOTE: The recommendation provided below is for application purposes only. TSA is under no obligation to contract with the airport operator / authority’s recommended vendor. Airport operator’s recommended company. Provide the company name and address.       Statement explaining the basis of the operator’s recommendation. Additional pages may be attached.      
Does the airport have any activities planned within the next 18 months, such as major construction or significant volume adjustments that would affect the screening operation? YES NO
Section IV. Optional Information
Provide any additional information you would like TSA to consider during the evaluation of this application. Additional pages may be attached.      
Section V. Signature
Upon execution of this application, the authorized representative, (specified as the primary point of contact in this document) hereby requests the TSA Administrator to approve this application to have the screening of passengers and property at the airport conducted by a privatized screening company contracted to the TSA, as provided for under Section 44901 of the Aviation and Transportation Security Act, as amended. TSA will evaluate this application in accordance with the criteria specified in section 44920, as amended, of Title 49, United States Code. If the application is approved, the airport operator understands that any potential contract resulting from the submission of this application will be awarded and administered by TSA in accordance with the Competition in Contracting Act and the Federal Acquisition Regulation. __________________________________ ____________________________ Signature Date of Execution (Application Date) ___________________________________ Print Name

PAPERWORK REDUCTION ACT BURDEN STATEMENT: TSA’s Screening Partnership Program (SPP) (49 U.S.C. § 44920 (ATSA §108)) enables commercial airports to apply for a private screening company to provide passenger and baggage security screening services.  Transportation Security Administration estimates that the average burden for collection is 15 minutes per response. This collection is required to obtain or retain benefits. You may submit any comments concerning the accuracy of this burden estimate or any suggestions for reducing the burden to: TSA-11, Attention: PRA 1652-xxxx 601 South 12th Street, Arlington, VA 20598. An agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a valid OMB control number.  The control number assigned to this collection is OMB No. 1652-xxxx, which expires MM/DD/YYYY.

Previous editions of this form are obsolete.

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