Information Collection

Law Enforcement Officers Safety Act (LEOSA) Photographic Identification Card Application

IC 248797 under ICR 202108-1405-002 · OMB 1405-0245.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1405-0245 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Law Enforcement Officers Safety Act (LEOSA) Photographic Identification Card Application	Form and Instruction
Law Enforcement Officers Safety Act Photographic ID Appl DSS Application Form.pdf	Form and Instruction
DS-7809 Law Enforcement Officers Safety Act (LEOSA) Photographic ds7809 - DRAFT - 11-22-2021.pdf	Form and Instruction

IC Title:

Law Enforcement Officers Safety Act (LEOSA) Photographic Identification Card Application

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Voluntary

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	DS-7809	Law Enforcement Officers Safety Act (LEOSA) Photographic Identification Card Application	ds7809 - DRAFT - 11-22-2021.pdf		Yes	Yes	Fillable Printable

Line of Business: Law Enforcement

Subfunction: Property Protection

Privacy Act System of Records

Title: 18 USC 926C

FR Citation: 86 FR 24133

Number of Respondents: 70

Number of Respondents for Small Entity: 0

Affected Public: Federal Government

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	70	70
Annual IC Time Burden (Hours)	70	70
Annual IC Cost Burden (Dollars)	1,758	1,758

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.