Information Collection

TSA Form 2825A LEOSA Identification Card Application

IC 234463 under ICR 202203-1652-006 · OMB 1652-0071.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1652-0071 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form TSA Form 2825A TSA Form 2825A LEOSA Identification Card Application	Form and Instruction
TSA Form 2825A LEOSA Identification Card Application TSA Form 2825A, LEOSA Identification Card Application.pdf	Form and Instruction
TSA Form 2825A LEOSA Identification Card Application TSA Form 2825A, LEOSA Identification Card Application.pdf	Form and Instruction

IC Title:

TSA Form 2825A LEOSA Identification Card Application

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

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
Form and Instruction	TSA Form 2825A	LEOSA Identification Card Application	TSA Form 2825A, LEOSA Identification Card Application.pdf		Yes	Yes	Fillable Printable

Line of Business: Homeland Security

Subfunction: Border and Transportation Security

Privacy Act System of Records

Title: DHS/TSA/SORN-002 Transportation Security Threat Assessment System

FR Citation: 79 FR 46862

Number of Respondents: 186

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	186	154	32
Annual IC Time Burden (Hours)	39	36	3
Annual IC Cost Burden (Dollars)	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.