OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

Field Office - online registration, injury waiver and class roster

IC 249267 under ICR 202109-1652-004 · OMB 1652-0028.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1652-0028 can be found here:

2024-09-13 - Extension without change of a currently approved collection

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form TSA Form 3417 CMSDT Program Attendance Roster Field Office - online registration, injury waiver and class roster	Form
Form TSA Form 3418 CMSDT Limited Assumption of Risk and Waiver of Responsibility Field Office - online registration, injury waiver and class roster	Form and Instruction
CMSDT online registration_feedback (2).pptx	Other-screenshot
CMSDT online registration_feedback (2).pptx	Other-screenshot
TSA Form 3417 CMSDT Program Attendance Roster TSA Form 3417, CMSDT Program Attendance Roster.docx	Form
TSA Form 3417 CMSDT Program Attendance Roster TSA Form 3417, CMSDT Program Attendance Roster.docx	Form
TSA Form 3418 CMSDT Limited Assumption of Risk and Waiver of Responsib TSA Form 3418, CMSDT Limited Assumption of Risk and Waiver of Responsibility.pdf	Form and Instruction
TSA Form 3418 CMSDT Limited Assumption of Risk and Waiver of Responsib TSA Form 3418, CMSDT Limited Assumption of Risk and Waiver of Responsibility.pdf	Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

Field Office - online registration, injury waiver and class roster

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

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
Other-screenshot					Yes	Yes	Fillable Fileable
Form	TSA Form 3417				Yes	Yes	Fillable Fileable
Form and Instruction	TSA Form 3418				Yes	Yes	Fillable Fileable

Federal Enterprise Architecture Business Reference Module

Line of Business: Homeland Security

Subfunction: Border and Transportation Security

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 3,500

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
	Approved	Program Change Due to New Statute	Program Change Due to Agency Discretion	Change Due to Adjustment in Agency Estimate	Change Due to Potential Violation of the PRA	Previously Approved
Annual Number of Responses for this IC	1,050	0	0	1,050	0	0
Annual IC Time Burden (Hours)	105	0	0	105	0	0
Annual IC Cost Burden (Dollars)	0	0	0	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.

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