TWIC Waiver and Appeals

Transportation Worker Identification Credential

twic_sample_pdi

TWIC Waiver and Appeals

OMB: 1652-0047

Document [pdf]
Download: pdf | pdf
U.S. Department of Homeland Security
Office of Transportation Threat Assessment and Credentialing
Arlington, VA 20598-6019

${Date}
${First Name} ${Last Name}
${Address}
${Address}
${City}, ${State} ${Zip Code}
${Country}
Re:

Preliminary Determination of Ineligibility, TWIC Application, Case Number ${Case Id}

Dear ${First Name} ${Last Name}:
The Transportation Security Administration (TSA) has received your application for a Transportation
Worker Identification Credential (TWIC). Based on the information reviewed, TSA has made a
preliminary determination that you might not be eligible for a TWIC because of your criminal history,

immigration eligibility, and mental incapacity, as described below:
Disqualifying Criminal Convictions, Open Criminal Dispositions, and/or Outstanding
Criminal Warrants:
Convictions:
[Cite Offense], in [City, State], on or about [Date], and sentenced to serve [days, months, or
years] incarceration.
Arrests/Complaints/Indictments/Open Criminal Dispositions:
[Cite Offense], in [City, State], on or about [Date].
Outstanding Criminal Wants or Warrants:
Held by the [insert Law Enforcement Agency], on [Date], in [City, State], for [Cite
Offense].
If you were not convicted of a disqualifying offense or you were convicted a long time ago,
you may qualify for an appeal. See the enclosed General Instructions for Criminal
Disqualifications, Section 1, regarding criminal appeals.
If the information above is correct, you may be able to obtain a TWIC in some cases. See
the enclosed General Instructions for Criminal Disqualifications, Section 2, regarding criminal
waivers.
Immigration Eligibility:
An individual applying for a TWIC must be:

•
•
•

a United States citizen;
a Lawful Permanent Resident; or
Meet the required immigration eligibility standards. See the enclosed Immigration Eligibility
Requirements and the enclosed General Instructions for Immigration Eligibility, Section 1,
regarding immigration eligibility appeals.

TSA is requesting that you submit additional documentation to address the below immigration matter:
Immigration Eligibility (Choose One):
On your application, you indicated that you were born in [Country]; however, TSA has been
unable to verify your U.S. citizenship or immigration eligibility to hold a TWIC.
On your application, you did not list your complete place of birth; therefore, TSA has been unable
to verify your U.S. citizenship or immigration eligibility to hold a TWIC.
On your application, you indicated that you were born in the United States; however, other records
available to TSA indicate that you may have been born in [Country]. As a result, TSA has been
unable to verify your U.S. citizenship or immigration eligibility to hold a TWIC.
On your application, you indicated that you were born in the United States; however, other records
available to TSA indicate that you may be a citizen of [Country]. As a result, TSA has been unable
to verify your U.S. citizenship or immigration eligibility to hold a TWIC.
On your application, you indicated you were born in the United States; however, you also indicated
that you were a citizen of [Country]. Therefore, TSA has been unable to verify your U.S.
citizenship or immigration eligibility to hold a TWIC.
If you meet the immigration eligibility requirements, you may qualify for an appeal. See the
enclosed General Instructions for Immigration Eligibility, Section 1, regarding immigration eligibility
appeals.
If you are currently in Temporary Protected Status (TPS) in the United States, you may qualify for
a waiver. See the enclosed General Instructions for Immigration Eligibility, Section 2, regarding
immigration eligibility waivers.
Mental Capacity:
Individuals who have either been adjudicated as lacking mental capacity or were once

involuntarily committed to a mental health facility are not eligible for a TWIC. Records
available to TSA indicate that you have either been adjudicated as lacking mental capacity or
were once involuntarily committed to a mental health facility. Specifically, our records indicate
that on or about [Date], you were adjudicated as lacking mental capacity or were committed to
the [insert name of mental institution] in [City, State].
If these facts are incorrect, you may qualify for an appeal. Your appeal request should be
accompanied by documentation showing that you were not adjudicated as lacking mental capacity
or were not involuntarily committed to a mental health facility.
If you no longer lack mental capacity, you may qualify for a waiver of the eligibility
requirements. Your waiver request should be accompanied by court records or official medical
release documents indicating that you no longer lack mental capacity.

If you do not know whether you should apply for an appeal or a waiver, you may request both. Read the
enclosed directions carefully before applying for an appeal or a waiver.
You may also request the releasable materials on which TSA has based its preliminary determination of
ineligibility. To do so, please check the appropriate box on the enclosed TWIC Response Cover Sheet
and return it to TSA.
In any case, you must reply within 60 days from the date you receive this letter. You may send TSA
the necessary documents or submit a request for an extension of time to reply. If you do not reply
within 60 days or receive an extension of time from TSA, TSA’s preliminary determination of
ineligibility will become final and you will not be granted a TWIC.
Even if your application is finally denied, you may submit a new application for a TWIC at any time.
A copy of the enclosed TWIC Response Cover Sheet should be included with all documents you
send to TSA. Please review the enclosure, which provides detailed instructions on how to submit
information to TSA. If you have questions, please write to us at the address provided.
For more information, you can also visit the TWIC home page on the internet at:
http://www.tsa.gov/what_we_do/layers/twic/index.shtm.
Sincerely,

Robert Freeman, Director
Adjudication Center
Office of Transportation Threat Assessment and
Credentialing

Enclosures

DISQUALIFYING CRIMINAL OFFENSES
If you have pleaded guilty or nolo contendere to a Disqualifying Offense, TSA treats the case
in the same way as if you had been convicted of the offense, even if the court withheld or
deferred adjudication of guilt.
TSA does not consider you to have been convicted if the finding of guilt was overturned on
appeal, pardoned (with full restoration of all rights), or expunged so that it has been removed
from your criminal record and carries no disabilities or restrictions (except for future sentencing
purposes).
If you are under want, warrant, complaint, or indictment for a Disqualifying Offense, you
will be disqualified until the want or warrant is released or the complaint or indictment is
dismissed.
If you were found not guilty by reason of insanity or incompetent to stand trial, you will be
disqualified until you provide proof that you no longer lack mental capacity.

If you have been convicted of
one of these felonies, you may
be eligible for an appeal if:

•

• You were convicted more
than 7 years before you
applied for your TWIC; and
• You were released from
confinement more than 5 years
before you applied for your
TWIC (if applicable).

If you were convicted less than
7 years before the date of your
application or released from
confinement less than 5 years
before the date of your
application, you may apply for a
waiver.

•
•

•
•
•
•
•
•
•
•
•
•
•

•

Unlawful possession, use, sale, manufacture, purchase,
distribution, receipt, transfer, shipping, transporting, delivery,
import, export of, or dealing in a firearm or other weapon. A
firearm or other weapon includes, but is not limited to,
firearms as defined in Title 18, United States Code (U.S.C.),
section 921(a)(3) or 26 U.S.C. section 5845(a), or items
contained on the U.S. Munitions Import List in Title 27, Code
of Federal Regulations (C.F.R.), section 447.21;
Extortion;
Dishonesty, fraud, or misrepresentation, including identity
fraud and money laundering where the money laundering is
related to a crime described in paragraphs (a) or (b) of this
section. Welfare fraud and passing bad checks do not
constitute dishonesty, fraud, or misrepresentation for purposes
of this paragraph;
Bribery;
Smuggling;
Immigration violations;
Distribution of, possession with intent to distribute, or
importation of a controlled substance;
Arson;
Kidnapping or hostage taking;
Rape or aggravated sexual abuse;
Assault with intent to kill;
Robbery;
Fraudulent entry into a seaport as described in 18 U.S.C.
section 1036, or a comparable State law;
Violations of the Racketeer Influenced and Corrupt
Organizations Act, 18 U.S.C. section 1961, et seq., or a
comparable State law, other than the violations listed in
paragraph (a)(10) of this section; and/or
Conspiracy or attempt to commit any of the above crimes.

If you have been convicted of
one of these felonies, you are
not eligible for an appeal, but
you may request a waiver (see
enclosed waiver instructions):

If you have been convicted of
one of these felonies, you
cannot receive a TWIC. You
are not eligible for an appeal,
and you may not request a
waiver.

•

A crime involving a transportation security incident. A
transportation security incident is a security incident resulting
in a significant loss of life, environmental damage,
transportation system disruption, or economic disruption in a
particular area, as defined in 46 U.S.C. section 70101. The
term ‘‘economic disruption’’ does not include a work
stoppage or other employee-related action not related to
terrorism and resulting from an employer-employee dispute;

•

Improper transportation of a hazardous material under 49
U.S.C. section 5124, or a State law that is comparable;

•

Unlawful possession, use, sale, distribution, manufacture,
purchase, receipt, transfer, shipping, transporting, import,
export, storage of, or dealing in an explosive or explosive
device. An explosive or explosive device includes, but is not
limited to, an explosive or explosive material as defined in 18
U.S.C. sections 232(5), 841(c) through 841(f), and 844(j); and
a destructive device, as defined in 18 U.S.C. section 921(a)(4)
and 26 U.S.C. section 5845(f);

•

Murder;

•

Making any threat, or maliciously conveying false
information knowing the same to be false, concerning the
deliverance, placement, or detonation of an explosive or other
lethal device in or against a place of public use, a state or
government facility, a public transportations system, or an
infrastructure facility;

•

Violations of the Racketeer Influenced and Corrupt
Organizations Act, 18 U.S.C. section 1961, et seq., or a
comparable State law, where one of the predicate acts found
by a jury or admitted by the defendant, consists of one of the
crimes listed in paragraph (a) of this section; and/or

•

Conspiracy or attempt to commit the above crimes.

•

Espionage, or conspiracy to commit espionage;

•

Sedition, or conspiracy to commit sedition;

•

Treason, or conspiracy to commit treason.

•

A federal crime of terrorism as defined in 18 U.S.C. section
2332b(g), or comparable State law, or conspiracy to commit
such crime; and/or

•

Attempt to commit the above crimes.

IMMIGRATION ELIGIBILITY REQUIREMENTS
Please send documentation to TSA to show that you are in one of the below eligible immigration
categories:
•
•
•
•
•
•

•

•

•
•
•

a U.S. citizen or citizen of one of the five U.S. Territories;
a Lawful Permanent Resident (LPR) of the U.S.;
a Refugee admitted under 8 U.S.C. section 1157;
an Alien granted asylum under 8 U.S.C. section 1158;
a Citizen of Micronesia, the Marshall Islands, or Palau;
a Canadian or Mexican citizen who is also a commercial driver licensed in
Canada or Mexico to transport hazardous materials and/or conduct business
in the U.S. under 8 C.F.R. section 214.2(b)(4)(i)(E);
an Alien in valid F-1 non-immigrant status enrolled at the U.S. Merchant
Marine Academy or comparable State maritime academy and sponsored by
the U.S. Maritime Administration (MARAD)
(Note: Visa must be accompanied by a letter from MARAD);
an Alien in valid J-1 non-immigrant status enrolled at the U.S. Merchant
Marine Academy or comparable State maritime academy and sponsored by
MARAD
(Note: Visa must be accompanied by a letter from MARAD);
an Alien in valid M-1 non-immigrant status enrolled at the U.S. Merchant
Marine Academy or comparable State maritime academy;
an Alien in valid R-1 (Religious Workers) status sponsored by MARAD
(Note: Visa must be accompanied by a letter from MARAD);
an Alien with unrestricted authorization to work in the U.S., holding
one of the following visa types:
• A-1: Immediate family members of an Ambassador, Public
Minister, Career Diplomat, Consular Officer, head of State, with a
bilateral agreement in place;
• A-2: Immediate family members of other foreign government
officials or employees coming to the U.S., including technical and
support staff of A-1, with a bilateral agreement in place;
• A-13 or A-14: Family Unity Program admitted under 8 C.F.R.
section 274a.12(a)(13) and (14);
• E-1: Spouse and dependent children of a treaty trader or employee
of a treaty trader;
• E-2: Spouse of a treaty investor or employee of a treaty investor;
• G-1:
Immediate family member of a principal resident
representative of recognized foreign member government to
international organization and staff, with a bilateral agreement in
place;
• G-3: Immediate family member of a representative of a nonrecognized or non-member foreign government to international
organization, with a bilateral agreement in place;
• G-4: Immediate family member of an international organization
officer or employee, with a bilateral agreement in place;
• J-2: Spouse or child of an exchange visitor (J-1);
• K-3: Spouse of U.S. citizen (under Legal Immigration Family
Equity (LIFE) Act provisions);

•
•
•
•

K-4: Child of K-3;
L-2: Spouse or child of L-1;
N-8: Parent of alien classified SK-3 "Special Immigrant;"
N-9: Child of N-8, SK-1, SK-2, or SK-4 "Special Immigrant;"
• Immediate family members of North Atlantic Treaty Organization
(NATO) officials and representatives, with a bilateral agreement in
place for the following visa types:
o NATO-1
o NATO-2
o NATO-3
o NATO-4
o NATO-5
o NATO-6
• S-7: Spouse, unmarried sons and daughters, and parents of a
witness or informant;
• T-1: Victim of a severe form of trafficking in persons;
• T-2: Spouse of victim of a severe form of trafficking in persons;
• T-3: Child of victim of a severe form of trafficking in persons;
• T-4: Parent of victim of a severe form of trafficking in persons (if
T-1 victim is under 21 years of age);
• T-5: Unmarried sibling under 18 years of age of a T-1 under 21
years of age;
• U-1: Victim of certain criminal activity;
• U-2: Spouse of U-1;
• U-3: Child of U-1;
• U-4: Parent of U-1 (if U-1 is under 21 years of age);
• U-5: Unmarried sibling under 18 years of age of a U-1 under 21
years of age;
• V-1: Spouse of a LPR who is the principal beneficiary of a
family-based visa petition, filed prior to December 21, 2000, and
has been pending for at least three years;
• V-2: Child of a LPR who is the principal beneficiary of a familybased visa petition, filed prior to December 21, 2000, and has been
pending for at least three years;
• V-3: Derivative child of a V-1 or V-2; OR
• TPS: Temporary Protected Status (TPS).
• an Alien with restricted authorization to work in the U.S., holding one
of the following visa types:
• B1 or B-1/B-2: Business Visitor requiring a TWIC
(Note: Visa must be annotated with ‘TWIC Letter Received’);
• BBBCV: B-1/B-2 and Border Crossing Card (BBC) (Mexican
citizens only);
• B-1/OCS: Business Visitor / Outer Continental Shelf (OCS)
(Note: Visa must be annotated with ‘Outer Continental Shelf’ or
‘OCS’);
• C-1/D: Combined transit and crewman visa;
• E-1 (Principal): Treaty trader or employee of treaty trader;

• E-2 (Principal): Treaty investor or employee of treaty investor;
• E-3: Australian nationals in specialty occupations and spouse of

Australian nationals in specialty occupations;
• H-1B: Specialty occupations; DOD workers, fashion models;
• H-1B1: Specialty occupations (professional)
(Note: Visa is only issued to Citizens of Chile or Singapore);
• L-1 (includes L-1A and L-1B): Executive, managerial (intracompany transferee) or specialized knowledge professionals
(Note: ‘L-1,’ ‘L-1A,’ or ‘L-1B’ may be displayed on the actual
visa);
• O-1 (includes O-1A and O-1B):
Extraordinary ability in
sciences, arts, education, business, athletics or extraordinary
achievement in motion picture and or television productions
(Note: ‘O-1,’ ‘O-1A,’ and ‘O-1B’ may be displayed on the actual
visa); OR
• TN: Trade visas for Canadian and Mexican business persons
seeking to engage in professional activities under the North
American Free Trade Agreement (NAFTA).
• The following visa types with unrestricted work authorization are NOT
eligible to obtain a TWIC:
• K-1: Fiancé(e) of a U.S. citizen;
• K-2: Minor child of K-1;
• S-5: Informant of criminal organization information; OR
• S-6: Informant of terrorism information.

GENERAL INSTRUCTIONS FOR CRIMINAL DISQUALIFICATIONS
1.

THE FACTS IN THE PRELIMINARY DETERMINATION OF INELIGIBILITY ARE INCORRECT
(I want to Appeal the Preliminary Determination of Ineligibility)

If you believe you were not convicted of a disqualifying offense, you may appeal TSA’s
preliminary determination of ineligibility.
You may also appeal TSA’s preliminary determination of ineligibility if you were convicted of
some disqualifying offenses more than 7 years ago, and were released from confinement more
than 5 years ago (if you were confined). See the enclosed list for these disqualifying offenses.
You must request your appeal in writing by filling out the enclosed TWIC Response Cover
Sheet. You must submit your appeal or request an extension of time within 60 days from
the date you receive this letter. Along with the cover sheet, you should send official
documents to show:
•

•
•
•

•
•

•

The open warrant issued for a disqualifying criminal offense was issued in
error, has been resolved, or did not result in a disqualifying felony criminal
conviction;
You are no longer under indictment for a disqualifying felony criminal offense;
You were convicted of a misdemeanor or lesser offense, were found not guilty,
or the charges were dismissed with no remaining legal restrictions;
The conviction was overturned on appeal, or expunged so that it has been
removed from your criminal record and carries no disabilities or legal
restrictions (except for future sentencing purposes);
You were allowed to withdraw a plea of guilty or nolo contendere and enter a
plea of not guilty, and the case was later dismissed;
For some, but not all felony convictions (see list of disqualifying offenses), you
were released from incarceration more than 5 years before you filed your
application and the conviction was incurred more than 7 years before you filed
your application; or
You received a full pardon (restoring all rights) for the disqualifying criminal
conviction.

TSA should notify you whether your appeal has been granted within 60 days after receiving your
request, or a longer period of time for good cause.
2.

I HAVE A DISQUALIFYING CONVICTION BUT I HAVE BEEN REHABILITATED AND I AM
ELIGIBLE TO HOLD A TWIC (I am r equesting a Waiver of the Pr eliminar y
Deter mination of Ineligibility)

If you were convicted of a disqualifying offense, you may still be able to obtain a TWIC by
requesting a waiver.
You must submit your request for a waiver in writing by filling out the enclosed TWIC
Response Cover Sheet. You must submit your waiver request or request an extension of
time within 60 days from the date you receive this letter. Along with the cover sheet, you

should send documents to show that you have rehabilitated yourself, as provided in the
five waiver criteria (49 C.F.R. section 1515.7), and that you are eligible to hold a TWIC.
The kinds of documents you should submit include, but are not limited to:
•
•
•
•
•
•
•
•
•
•
•

An explanation of the circumstances of the disqualifying offense(s);
Official documents showing any restitution ordered, restitution paid, and the balance due;
Any Federal or state mitigation remedies (such as certificates showing completion of
court-ordered substance abuse or other treatment programs);
Court records or official medical release documents indicating that you no longer lack
mental capacity (if you were found not guilty by reason of insanity);
Official court documents regarding the offense and the disposition of your case (e.g.,
indictment, judgment of conviction, and sentencing documents);
Official documents demonstrating the completion of all terms of your sentence (including
the date of release from incarceration, date of discharge from supervision, etc.);
A letter from your probation and/or parole officer discussing compliance while under
supervision (including any violations);
Letters of recommendation from past and present employers;
Character reference letters from friends, family members or co-workers;
Performance appraisals, certificates of achievement or accomplishments, etc.; and
Any other information you believe would aid TSA in determining whether you are eligible
for a waiver.

TSA should notify you whether your request for a waiver has been granted or denied within 60
days after receiving your request, if you provided all of the necessary information. The decision
may take longer than 60 days if additional information is required for TSA to render a decision.
3.

I WANT TO KNOW WHAT INFORMATION TSA USED TO MAKE ITS P RELIMINARY
DETERMINATION OF I NELIGIBILITY

You may request copies of the information and documents (Releasable Materials) that TSA used
to determine that you might not be eligible to hold a TWIC. You must submit your request for
Releasable Materials by filling out the enclosed TWIC Response Cover Sheet. You do not
need to give any explanation for your request.
TSA will normally give you a copy of the Releasable Materials no later than 60 days after
receiving your request, or a longer period of time for good cause. TSA does not disclose
classified information, as defined in Executive Order 12968, Section 1.1(d), and TSA reserves
the right not to disclose any other information or material that is protected from disclosure under
law or that TSA did not use in making its preliminary determination of ineligibility.
4.

I NEED MORE TIME TO PREPARE MY REQUEST FOR AN APPEAL, MY REQUEST FOR A
WAIVER, OR MY REQUEST FOR RELEASABLE MATERIALS

If you need additional time in which to submit a request for documents, materials, information, a
waiver, or an appeal, you may ask for an extension of time. You must submit your request for
an extension of time by filling out the enclosed TWIC Response Cover Sheet. You must
submit your request within 60 days from the date you receive this letter. Your first request

for an extension of time will be granted automatically, which will give you an additional 60
days to submit your request for an appeal or a waiver.
If you need more than one extension of time, you must submit another request in writing to
TSA, and you will be notified of the new date by which you must provide documents to TSA in
support of your request for an appeal or a waiver.
If the time period to submit a request for documents, materials, information, a waiver, or an
appeal has expired, you may send a written request to explain why the failure to respond within
the time limit was excusable. TSA will grant an extension of time after the expiration of the time
period if good cause is shown, and will notify you of the new date by which you must provide
documents to TSA.
5.

HOW TO SEND DOCUMENTS TO TSA

Before submitting your TWIC Response Cover Sheet, please make sure that your printed
name and address are correct. If they are not, please make any necessary corrections and be
sure to include a telephone number where you can be reached during the day.
DOCUMENTS MAY BE MAILED VIA U.S. POSTAL SERVICE TO THE ADDRESS PROVIDED ON THE
TWIC RESPONSE COVER SHEET OR YOU MAY FAX YOUR DOCUMENTATION TO (540) 710-2763
OR (540) 710-2783, ATTN: TSA TWIC PROCESSING CENTER.
If you use an overnight mail service, make sure that the mail carrier delivers to a Post Office
Box. Currently, only the U.S. Postal Service delivers to Post Office Boxes. In addition to
Express Mail, you may also write to TSA using registered, certified, priority, or regular mail.
Using the enclosed TWIC Response Cover Sheet and faxing or mailing documents to the
address on the cover sheet is the fastest way to communicate with TSA.

GENERAL INSTRUCTIONS FOR IMMIGRATION ELIGIBILITY
1.

I AM WITHIN AN ELIGIBLE IMMIGRATION CATEGORY
(I want to Appeal the Preliminary Determination of Ineligibility)

If you are in an eligible immigration category, you may appeal TSA’s preliminary determination
of ineligibility.
You must request your appeal in writing by filling out the enclosed TWIC Response Cover
Sheet. You must submit your appeal or request an extension of time within 60 days from
the date you receive this letter. Along with the cover sheet, you should send a copy (front and
back) of documents to show that you:
•
•
•
•

Are a U.S. citizen or citizen of one of the five U.S. Territories;
Are a Lawful Permanent Resident of the United States;
Hold a Visa that is approved for this program; or
Are a Refugee, or an Alien who has been granted asylum.

TSA should notify you whether your appeal has been granted within 60 days after receiving your
request, or a longer period of time for good cause.
2.

I AM CURRENTLY IN TEMPORARY PROTECTED STATUS (TPS)
(I want a Waiver of the Preliminary Determination of Ineligibility)

You may apply for a waiver if you are an alien, currently under TPS, with unrestricted authorization to
work in the United States.

You must request your waiver in writing by filling out the enclosed TWIC Response Cover
Sheet. You must submit your waiver or request an extension of time within 60 days from
the date you receive this letter. Along with the cover sheet, you should send a copy (front and
back) of documents to show that you are in Temporary Protected Status.
3.

I WANT TO KNOW WHAT INFORMATION TSA USED TO MAKE ITS P RELIMINARY
DETERMINATION OF I NELIGIBILITY

You may request copies of the information and documents (Releasable Materials) that TSA used
to determine that you might not be eligible to hold a TWIC. You must submit your request for
Releasable Materials by filling out the enclosed TWIC Response Cover Sheet. You do not
need to give any explanation for your request.
TSA will normally give you a copy of the Releasable Materials no later than 60 days after
receiving your request, or a longer period of time for good cause. TSA does not disclose
classified information, as defined in Executive Order 12968, Section 1.1(d), and TSA reserves
the right not to disclose any other information or material that is protected from disclosure under
law or that TSA did not use in making its preliminary determination of ineligibility.

4.

I NEED MORE TIME TO PREPARE MY REQUEST FOR AN APPEAL, MY REQUEST FOR A
WAIVER, OR MY REQUEST FOR RELEASABLE MATERIALS

If you need additional time in which to submit a request for documents, materials, information, a
waiver, or an appeal, you may ask for an extension of time. You must submit your request for
an extension of time by filling out the enclosed TWIC Response Cover Sheet. You must
submit your request within 60 days from the date you receive this letter. Your first request
for an extension of time will be granted automatically, which will give you an additional 60 days
to submit your request for an appeal or a waiver.
If you need more than one extension of time, you must submit another request in writing to
TSA, and you will be notified of the new date by which you must provide documents to TSA in
support of your request for an appeal or a waiver.
If the time period to submit a request for documents, materials, information, a waiver, or an
appeal has expired, you may send a written request to explain why the failure to respond within
the time limit was excusable. TSA will grant an extension of time after the expiration of the time
period if good cause is shown, and will notify you of the new date by which you must provide
documents to TSA.
5.

HOW TO SEND DOCUMENTS TO TSA

Before submitting your TWIC Response Cover Sheet, please make sure that your printed
name and address are correct. If they are not, please make any necessary corrections and be
sure to include a telephone number where you can be reached during the day.
DOCUMENTS MAY BE MAILED VIA U.S. POSTAL SERVICE TO THE ADDRESS PROVIDED ON THE
TWIC RESPONSE COVER SHEET OR YOU MAY FAX YOUR DOCUMENTATION TO (540) 710-2763
OR (540) 710-2783, ATTN: TSA TWIC PROCESSING CENTER.
If you use an overnight mail service, make sure that the mail carrier delivers to a Post Office
Box. Currently, only the U.S. Postal Service delivers to Post Office Boxes. In addition to
Express Mail, you may also write to TSA using registered, certified, priority, or regular mail.
Using the enclosed TWIC Response Cover Sheet and faxing or mailing documents to the
address on the cover sheet is the fastest way to communicate with TSA.

TWIC RESPONSE COVER SHEET
FROM:

${First Name} ${Last Name}
${Address}
${Address}
${City}, ${State} ${Zip Code}
${Country}

TWIC Case No.: ${Case Id}

Daytime Telephone Number: ______________________________________
(Area Code)
DIRECTIONS FOR THE APPLICANT
(1) Review and correct the above information as needed; (2) Select from the options listed below by marking the
appropriate box(es); and (3) Attach this cover sheet to the front of any documentation submitted to TSA.
℉ EXTENSION OF TIME: I require more than 60 days to obtain documentation for my appeal or waiver request.
℉ REQUEST FOR RELEASABLE MATERIALS: I request a copy of my FBI rap sheet or other releasable
materials.
℉ APPEAL: I dispute the preliminary determination of ineligibility because (check all appropriate boxes and provide
supporting documentation):
CRIMINAL RECORD ISSUES:
[ ] My arrest/indictment did not result in a felony conviction
[ ] I was convicted of a misdemeanor offense, not a felony
[ ] I received a pardon
[ ] My conviction was overturned on appeal
[ ] My conviction was expunged
[ ] My conviction is more than 7 years old and I was never incarcerated
[ ] My conviction is more than 7 years old and I was released from incarceration more than 5 years ago
[ ] Other (an explanation must be provided) ___________________________________________________
CITIZENSHIP/IMMIGRATION ELIGIBILITY ISSUES:
[ ] I am a U.S. citizen or citizen of one of the five U.S. Territories
[ ] I am a Lawful Permanent Resident of the United States
[ ] I hold a visa that is approved for this program
[ ] I am a refugee, or an alien who has been granted asylum
[ ] Other (an explanation must be provided) ___________________________________________________
[ ] MENTAL CAPACITY ISSUES: I was not adjudicated as lacking mental capacity or committed to a mental
health facility.
℉ WAIVER: I have one or more disqualifications, but seek to have TSA waive the disqualification(s) because (check
all appropriate boxes and provide supporting documentation):
[ ] My offense(s) dates back several years and I have no subsequent convictions
[ ] My criminal record does not show repeated felony convictions
[ ] I have evidence demonstrating my rehabilitation
[ ] I am an alien in Temporary Protected Status
[ ] Court records or official medical release documents indicate that I no longer lack mental capacity
[ ] Other (an explanation must be provided) ___________________________________________________
Correspondence may be submitted to TSA as follows:
*Via U.S. Postal Service:
*Via Facsimile:
Transportation Security Administration
ATTN: TSA TWIC Processing Center
TSA TWIC Processing Center
Fax Number: 540-710-2763; or
P.O. Box 8118
Fax Number: 540-710-2783
Fredericksburg, VA 22404-8118
Please ensure that all documentation provided for TSA’s reconsideration of the preliminary determination of ineligibility
is attached. Closely following these directions will help ensure expedited processing of your request.


File Typeapplication/pdf
File TitleMonth Day, Year
AuthorTSA Standard PC User
File Modified2011-06-09
File Created2011-06-09

© 2024 OMB.report | Privacy Policy