TSA Form 419E CCSF Security Profile

DEPARTMENT OF HOMELAND SECURITY

Transportation Security Administration

OMB 1652-0053
Exp. 09/30/2024

CERTIFIED CARGO SCREENING FACILITY (CCSF) Security Profile
INSTRUCTIONS: Companies seeking to be designated as a Certified Cargo Screening Facility (CCSF) must sign this form. A
separated form must be submitted with each application, and the completed form must be submitted as part of the CCSF application
package via email to [email protected] as a protected data file (PDF).
NOTE: A complete CCSF application package includes TSA Form 419A CCSF Letter of Intent, TSA Form 419B CCSF Facility
Profile Application, TSA Form 419C CCSF SSI Agreement, TSA Form 419D CCSF Principal Attestation, and TSA Form 419E Security
Profile. Upon receipt of the complete application package TSA will distribute the Certified Cargo Screening Standard Security Program
(CCSSSP).
If additional space is needed, please provide in a separate document.
Section I. General Security Profile Information
Is your facility wholly owned by your company or are
parts rented to other 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 an 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.).

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

OMB control number 1652-0053; Expiration Date: 09/30/2024

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 (i.e. driver’s
license or passport) required of visitors entering the
facility? If so, are the visitors registered (i.e. utilization
of a log)?
Describe any procedures in place to identify, challenge,
and address unauthorized persons.
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.).
Section V. 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?

Page 2 of 3
TSA Form 419E, (3/16) rev.[File: 400.18]

OMB control number 1652-0053; Expiration Date: 09/30/2024

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 designated employees/contractors successfully
completed a TSA Security Threat Assessment (STA) in
accordance with 49 CFR 1540.201?
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 VI. 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 the 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.

Previous editions of this form are obsolete.

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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 09/30/2024.

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

OMB control number 1652-0053; Expiration Date: 09/30/2024