Submitting Payment Information

TSA Claims Application

Documents and Forms

Document Name Document Type
0-0-1 Approval_rtf - 2-7-22.docx Other-Letter
0-0-1 Approval_rtf - 2-7-22.docx Other-Letter
0-0-2 Settlement_updated rtf - 2-7-22.docx Other-Letter
0-0-2 Settlement_updated rtf - 2-7-22.docx Other-Letter
0-0-9 Reeval- Settlement_2-7-22.docx Other-Letter
0-0-9 Reeval- Settlement_2-7-22.docx Other-Letter
0-0-10 Reeval -Settlement 50. 2-7-22.docx Other-Letter
0-0-10 Reeval -Settlement 50. 2-7-22.docx Other-Letter

Information Collection (IC) Details

IC Title:	Submitting Payment Information	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Letter	0-0-1 Approval_rtf - 2-7-22.docx	Yes	Yes	Fillable Printable
Other-Letter	0-0-2 Settlement_updated rtf - 2-7-22.docx	Yes	Yes	Fillable Printable
Other-Letter	0-0-9 Reeval- Settlement_2-7-22.docx	Yes	Yes	Fillable Printable
Other-Letter	0-0-10 Reeval -Settlement 50. 2-7-22.docx	Yes	Yes	Fillable Printable

Line of Business: Homeland Security

Subfunction: Border and Transportation Security

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 1,250	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 50 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	1,250	50	1,200
Annual IC Time Burden (Hours)	208	8	200
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

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.