Form DHS Form SF317 DHS Form SF317 TELECOMMUNICATIONS SERVICE PRIORITY (TSP) SYSTEM TSP ACT

TELECOMMUNICATIONS SERVICE PRIORITY (TSP) SYSTEM
TSP ACTION APPEAL FOR SERVICE USERS

OMB No. 1670-0005
Expires: 11/30/2014

(See Instructions on back before completion.)

The public reporting burden for this collection of information is estimated to average 25 minutes per response, including the time for reviewing instructions, searching
existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden
estimate or any other aspect of this collection of information, including suggestions for reducing the burden, to DHS, NPPD/CS&C/OEC (Attn: TSP Program Office),
245 Murray Lane, Washington, DC 20598-0615. Respondents should be aware that not withstanding any other provision of law, no person shall be subject to any
penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number.

1. APPEAL REQUESTOR INFORMATION
a. NAME/TITLE

b. ORGANIZATION (Dept/Agency)

c. MAILING ADDRESS

d. CITY/STATE/ZIP CODE
f. SIGNATURE

e. TELEPHONE NUMBER (Area Code/
Number/Extension)

g. DATE

2. APPEAL RATIONALE (Attach additional sheets as necessary)

3. SPONSORSHIP INFORMATION FOR A NON-FEDERAL USER (To be completed by sponsor)
b. SPONSOR NAME/TITLE
a. FEDERAL SPONSORING AGENCY

c. TELEPHONE NUMBER (Area Code/
Number/Extension)

d. RECOMMENDED DISPOSITION

e. SPONSOR SIGNATURE

f. DATE

NOTE: Attach all information submitted to and received from the Manager, NCS regarding the appeal. Send a copy, clearly marked as an
information copy, to the Federal Communications Commission.
Send copy to:

Send completed form to:

DHS, NPPD/CS&C/OEC
(Attn: TSP Program Office),
245 Murray Lane,
Washington, DC 20598-0615

Federal Communications Commission
Attn: Chief, Domestic Services Branch
Common Carrier Bureau
Washington, DC 20554

TO BE COMPLETED BY THE TSP PROGRAM OFFICE
4. RESOLUTION OF APPEAL:

GRANTED

DENIED

5. COMMENTS

6. APPROVED BY
a. NAME
b. SIGNATURE

AUTHORIZED FOR LOCAL REPRODUCTION
PREVIOUS EDITION IS NOT USABLE

c. DATE

STANDARD FORM 317 (Revised 08/2014)

INSTRUCTIONS FOR TSP ACTION APPEAL
Complete this form only if you are a service user or sponsoring Federal organization appealing an action taken by the TSP
Program Office.
Item 1. Appeal Requestor Information. Provide the name and commercial phone number (area code/phone/extension) of an
individual knowledgeable about this appeal.
Item 2. Appeal Rationale. Explain the reason for your appeal. Use additional sheets if required. Attach copies of all relevant
correspondence.
Item 3. Sponsorship Information for a Non-Federal User. This information MUST be completed and signed by the sponsoring
activity.

APPEAL PROCESS
1. Service users or sponsoring Federal Organizations may appeal any priority level assignment, denial, revision, revocation,
approval, or disapproval to the TSP Program Office within 30 days of notification to the service user. The appeal must include
supporting factual details. (NOTE: Non-Federal service users must appeal through their sponsor.) An appeal that includes a claim
of new information may be submitted at any time.
2. Service users may appeal any priority action to the TSP Program Office within 30 days of notification of the action. All TSP
appeals must be filed using this form. Submit the completed appeal form, along with copies of any relevant correspondence, to
the TSP Program Office. A copy of the appeal package, clearly marked as an information copy, must also be submitted to the
Federal Communications Commission (FCC). The TSP Program Office will determine the disposition of the appeal and respond
within 30 days of receipt.
3. If the service user is not satisfied with the TSP Program Office's decision, they may then escalate the appeal to the Manager,
NCS. This escalation must be submitted within 30 days of the TSP Program Office's notice of action on the initial appeal. The
service user will submit a letter explaining the reason for escalating the appeal and attach the appeal package previously
submitted to the TSP Program Office. The Manager, NCS will determine the disposition of the appeal and respond to the service
user within 30 days of receipt.
4. Service users may only appeal a priority action directly to the FCC after first submitting an appeal to the TSP Program Office
and escalating the appeal to the Manager, NCS. This appeal must be submitted to the FCC within 30 days of notification of the
decision made by the Manager, NCS on the escalated appeal. The service user will submit a letter to the FCC Common Carrier
Bureau detailing the reasons for appealing the decision made by the Manager, NCS. Copies of the letter of appeal to the FCC will
be submitted to the TSP Program Office, Manager, NCS, and any other parties directly involved. The FCC will not issue a public
notice of an appeal. The FCC will provide notice of its decision on the appeal to all parties of record.
5. Following the FCC's decision, involved parties may file a response to the FCC within 20 days of the FCC's appeal
determination. The organization that originally filed the appeal may then file replies to the FCC's decision within 10 days of the
FCC's response. Additionally, the TSP Program Manager may appeal any FCC revision, approval, or disapproval to the FCC.

Privacy Act Notice
Authority: This information collection is authorized by 5 U.S.C. §301 and 44 U.S.C. §3101.
Purpose: DHS will use this information to provide Telecommunications Service Priority (TSP) users and vendors
with information relating to TSP requests and to resolve specific cases of customer service.
Routine Uses: The information collected may be disclosed as generally permitted under 5 U.S.C. § 552a(b) of the
Privacy Act of 1974, as amended. This includes using the information, as necessary and authorized by the routine
uses published in DHS/ALL 002 Department of Homeland Security Mailing and Other Lists System.
Disclosure: Furnishing this information is voluntary; however, failure to furnish the requested information may delay
or prevent your registration or verification for continued use of service.
STANDARD FORM 317 (Revised 08/2014)