TSA Form 419E CCSF Security Profile

OMB 1652-0053

Exp. 07/31/2021

DEPARTMENT OF HOMELAND SECURITY

Transportation Security Administration

CERTIFIED CARGO SCREENING FACILITY (CCSF) Security Profile

INSTRUCTIONS: This form must be completed by companies seeking to be designated as a Certified Cargo Screening Facility (CCSF). A separate form must be submitted for each facility. Submit the completed form via email to [email protected]. NOTE: When sending the form via email it must be a protected data file (pdf). Upon receipt of the completed CCSF application package, TSA will distribute the Certified Cargo Screening Program draft regulatory order, the Certified Cargo Screening Program Standard Security Program the Indirect Air Carrier Standard Security Program Alternate Procedures and the Facility Security Plan guidelines as applicable. A completed CCSF application consists of TSA Form 419A, CCSF SSI Acknowledgement, TSA Form 419D Principal Attestation, TSA Form 419E, Security Profile.
Section I. General Security Profile Information
Please provide a 24-hour contact phone number for the facility or an individual. (required)
Is your facility wholly owned by your company or are parts rented to discrete entities? Please explain which percentage is occupied by your company.
What is the general purpose of this facility? What activities occur (i.e. office space, manufacturing, warehouse packing, etc.)?
Is the site normally open to the public?
Which hours and days represent high activity use of the facility?
How many people have unescorted access to the facility (i.e. employees, contractors, vendors, etc.)?
Section II. Physical Security Information
Describe the construction materials that comprise the exterior of the facility (i.e. concrete, wood, brick, etc.).
How are the facility entry points protected (i.e. guarded by personnel, CCTV, swipe badges, etc.)?
Does this facility have Closed Circuit Television? If so, please describe its use (i.e., is it monitored continuously)? If recorded, what is the length of retention? Is it used for surveillance, access control, recording capabilities?
Do you have any full-time security personnel at this facility (i.e direct employee or contracted)? If so, please describe their roles and duties.
How do you respond to security related events at your facility? Does your facility have a emergency response plan?
Section III. Access Controls
Is the movement within the building controlled? If so, please describe how movement is controlled (i.e. escorts, guards, locked/secured areas, etc.).
Do you have an access control system? If yes, please describe the method (i.e. swipe badges, bio metric controls, etc.).
How is the employee entrance(s) to the facility controlled during normal business hours?
How is the employee entrance(s) to the facility controlled after normal business hours?
Is identification media issued to employees?
Is the wearing of this media required (i.e. visible above waist)?
If yes, how is the wearing of identification media enforced?
Are there prohibited areas for some employees, or is the entire facility accessible by all employees? If there are prohibited areas, how is the movement of employees controlled (i.e. swipe badges, key locks, etc.)?
Is a form of government identification, driver’s license or passport for instance, required of visitors entering the facility? And if so, are the visitors registered (i.e. utilization of a log)?
Describe any procedures in place to identify, challenge and address unauthorized persons.

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Section IV. Procedural & Personnel Security
Has management established and communicated a general security policy to employees?
Have security procedures been published and disseminated to employees (i.e. team meetings, email, formal training)?
Is there a designated individual to supervise a security program at this site?
What mechanisms do you use to protect sensitive and/or important files and computer operations secured (i.e. safe, locked cabinet, locked office, etc.)?
What mechanism will you use to protect Sensitive Security Information (SSI) both digital and hardcopy (i.e. safe, locked cabinet, locked office, etc.)?
Does the company conduct pre-employment background checks on all potential employees and/or contractors? If so, please describe the type of background check (i.e. criminal history, credit, etc.).
Have you designated employees/contractors successfully completed a TSA Security Threat Assessment (STA) in accordance with the Alternative Procedure for the IAC Standard Security Program or TSA Order?
If not, how many individuals do you intend to submit for review?
Describe your process for releasing personnel no longer employed. (i.e. formal exit interview) What procedures are in place to maintain a secure facility (i.e. required to turn in technology, ID badge, keys, deletion of access codes, etc.)?
Section V. Designated Screening Area (DSA)
What screening methods will you use to screen cargo at your facility (i.e. AT X- ray, ETD, EDS, physical search, etc.)?
Please describe what mechanism will be in place to secure the DSA (i.e., fencing, physical barriers, guards, CCTV, etc.)?
How will access points leading into the DSA be secured (i.e. card swipe, bio metrics, guard, etc.)?
What is expected response plan in the event of a DSA breach?
What is your plan for security/maintaining chain of custody once your cargo has been screened (i.e. escorts, tamper evidence technology, seals, bolts, etc.)?
Will you have any part-time or seasonal employment in the DSA? If so, please explain.
Please describe any other security related items planned for the DSA.

PAPERWORK REDUCTION ACT BURDEN STATEMENT: TSA is collecting this information to qualify entities as Certified Cargo Screening Facilities. The public burden for this collection of information is estimated to be approximately 90 minutes. This is a mandatory collection of information. Send comments regarding this burden estimate or any other aspect of this collection to: TSA-11, Attention: PRA 1652-0053, 6595 Springfield Center Drive, Springfield, VA 20598-6028. An agency may not conduct or sponsor, and persons are not required to respond to, a collection of information unless it displays a currently valid OMB control number. The OMB control number assigned to this collection is 1652-0053, which expires 07/31/2021.

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TSA Form 419E, (3/16) rev. [File: 400.18]

OMB control number 1652-0053; Expiration Date: 07/31/2021