Information Collection

3PK9-C Certifier STA Applications

IC 236731 under ICR 201906-1652-004 · OMB 1652-0053.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1652-0053 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form TSA Form 419F 3PK9-C Certifier STA Applications	Form and Instruction
TSA Form 419F Security Threat Assessment TSA Form 419F draft07092019.docm	Form and Instruction

IC Title:

3PK9-C Certifier STA Applications

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	TSA Form 419F	Security Threat Assessment	TSA Form 419F draft07092019.docm		Yes	Yes	Fillable Fileable

Line of Business: Homeland Security

Subfunction: Border and Transportation Security

Privacy Act System of Records

Title: DHS/TSA-002, Transportation Security Threat Assessment System

FR Citation: 79 FR 46862

Number of Respondents: 58

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate
Annual Number of Responses for this IC	58	58
Annual IC Time Burden (Hours)	15	15
Annual IC Cost Burden (Dollars)	0	0

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.