Information Collection

Law Enforcement Officers Safety Act (LEOSA) Credential Program

IC 227796 under ICR 202011-0703-002 · 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⚠️ Notice: This information collection may be referencing outdated material.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

Document Name Document Type
0703_0067_USMC Screenshot_11.20.2020.doc.pdf www.leosanavy.com and www.usmcleosa.com Other-Screenshots
0703-0067_NAVY Screenshots of LEOSA Application Process_11.23.2020.docx Other-Screenshots
0703_0067_NAVY LEOSA PAS and ADN_11.25.2020.pdf Other-Screenshots
0703-0067_USMC LEOSA PAS and ADN_11.25.2020.pdf Other-Screenshots
0703_0067_USMC LEOSA Website application process Collection Instrument.11.23.2020.pdf Other-Screenshots

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Law Enforcement Officers Safety Act (LEOSA) Credential Program	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Screenshots	0703_0067_USMC Screenshot_11.20.2020.doc.pdf	https://www.leosanavy.com and www.usmcleosa.com	Yes	Yes	Fillable Fileable
Other-Screenshots	0703-0067_NAVY Screenshots of LEOSA Application Process_11.23.2020.docx		Yes	Yes	Fillable Fileable
Other-Screenshots	0703_0067_NAVY LEOSA PAS and ADN_11.25.2020.pdf		Yes	Yes	Fillable Fileable
Other-Screenshots	0703-0067_USMC LEOSA PAS and ADN_11.25.2020.pdf		Yes	Yes	Fillable Fileable
Other-Screenshots	0703_0067_USMC LEOSA Website application process Collection Instrument.11.23.2020.pdf		Yes	Yes	Fillable Fileable

Line of Business: Defense and National Security

Subfunction: Operational Defense

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 250	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	250	-650	900
Annual IC Time Burden (Hours)	500	-1,300	1,800
Annual IC Cost Burden (Dollars)	13,600	-28,808	42,408

Documents for IC

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.