TSA Form 3415 Armed Security Officer Training Acknowledgement

DEPARTMENT OF HOMELAND SECURITY

OMB Control Number: 1652-0035
Expiration: 07/31/2019

Transportation Security Administration

ARMED SECURITY OFFICER TRAINING ACKNOWLEDGEMENT
INSTRUCTIONS: In order to participate in the Transportation Security Administration (TSA) Law Enforcement/Federal Air Marshal Service
(LE/FAMS) Armed Security Officer (ASO) Program and in accordance with ASO Standard Operating Procedures (SOP) each ASO shall
certify that they have read, understand and adhere to the ASO SOP, Department of Homeland Security’s Policy Statement
044-05, Department Policy on the Use of Force, and TSA Insider Threat Program (FFDO and ASO) Training Module.
This form shall be completed annually and stored in accordance with TSA File Code 3400.21.
SECTION I. Acknowledgement of ASO SOP, DHS Policy on the Use of Deadly Force and Insider Threat Training
I acknowledge I have read, understand and shall adhere to the ASO SOP.
I acknowledge I have read, understand and shall adhere to the Department of Homeland Security’s Policy Statement 044-05, Department Policy on
the Use of Force.
I acknowledge I have read, understand and shall adhere to the TSA Insider Threat Program (FFDO and ASO) Training Module.

SECTION II. ASO Information and Signature
ASO Credential Number
ASO Name (Printed)
ASO Signature
Date of Signature
PRIVACY ACT STATEMENT: AUTHORITY: 49 U.S.C. § 114(f). PRINCIPAL PURPOSE(S): This information will be used to document your acknowledgment
that you have read, understand and will adhere to the listed policies and procedures. ROUTINE USE(S): This information may be shared with another federal
agency in response to its request, in connection with the hiring or retention of an employee or the issuance of a security clearance, or for routine uses
identified in TSA system of records, DHS/TSA 002, Transportation Security Threat Assessment System (T-STAS). DISCLOSURE: Voluntary; failure to furnish
the requested information may result in an inability to document your acknowledgment that you have read, understand and will adhere to the listed policies and
procedures.
PAPERWORK STATEMENT ACT: This is a mandatory collection to participate in the ASO Program. The total average burden per response associated with
this collection is estimated to be approximately 5 minutes. 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 0MB control number. The control number assigned to this collection is OMB 1652- 0035, which will expire on July 31, 2019.
Send comments regarding this burden estimate or collection to: TSA-11, Attention: PRA 1652-0035, 601 South 12th Street, Arlington, VA 20598-6011.

TSA Form 3415 (2/19) [File: 3400.21]

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