Information Collection

Law Enforcement Officers Safety Act (LEOSA) Credential Program

IC 227796 under ICR 201708-0703-001 · OMB 0703-0067.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0703-0067 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
USMC LEOSA Website application process 05052017.pptx	Other-Website Application
Screen Shots (Navy LEOSA Process).doc	Other-Website
SECNAV 5580 Credential Application Draft SECNAV 5580 1 LEOSA.pdf	Form and Instruction

IC Title:

Law Enforcement Officers Safety Act (LEOSA) Credential Program

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

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
Other-Website Application			USMC LEOSA Website application process 05052017.pptx	Yes	Yes	Fillable Fileable
Other-Website			Screen Shots (Navy LEOSA Process).doc	Yes	No	Fillable Printable
Form and Instruction	SECNAV 5580	Credential Application	Draft SECNAV 5580 1 LEOSA.pdf	Yes	No	Fillable Printable

Line of Business: Defense and National Security

Subfunction: Operational Defense

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 900

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 11 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	900	900
Annual IC Time Burden (Hours)	1,800	1,800
Annual IC Cost Burden (Dollars)	42,408	42,408

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.