Information Collection

Other 49 CFR 1520.15(e)

IC 227228 under ICR 202102-1652-001 · OMB 1652-0042.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1652-0042 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form TSA Form 2817B Other 49 CFR 1520.15(e)	Form and Instruction
TSA Form 2817B SSI ACCESS THREAT ASSESSMENT QUESTIONNAIRE - STANDARD TSA-Form2817BFINALv210108.docx	Form and Instruction

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 49 CFR 1520.15(e)

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 2817B	SSI ACCESS THREAT ASSESSMENT QUESTIONNAIRE - STANDARD	TSA-Form2817BFINALv210108.docx		Yes	Yes	Fillable Fileable

Line of Business: Homeland Security

Subfunction: Border and Transportation Security

Privacy Act System of Records

Title: SSI ACCESS THREAT ASSESSMENT QUESTIONNAIRE - STANDARD

FR Citation: 79 FR 46862

Number of Respondents: 20

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Requested	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	20	0	20
Annual IC Time Burden (Hours)	5	-15	20
Annual IC Cost Burden (Dollars)	0	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.