RETIRED/FORMER DSS LAW ENFORCEMENT OFFICER LEOSA PHOTOGRAPHIC IDENTIFICATION CARD APPLICATION

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form DS-7809 Law Enforcement Officers Safety Act (LEOSA) Identification Cards	Form and Instruction	New	Repair queued
Form DS-7809 Law Enforcement Officers Safety Act (LEOSA) Photographic Identification Card Application	Form and Instruction	Unchanged	Repair queued
Form DS-7809 Law Enforcement Officers Safety Act (LEOSA) Photographic Identification Card Application	Form and Instruction	Unchanged	Missing upstream
30-day LEOSA -Legal Authorities.docx	Supplementary Document	Uploaded 2026-01-15	Repair queued
Legal Authorities.docx	Supplementary Document	Uploaded 2024-11-13	Repair queued
legalAuthorities - LEOSA.docx	Supplementary Document	Uploaded 2021-08-10	Missing upstream
LEOSA- Supporting Statement (002).docx	Supporting Statement A	Uploaded 2026-01-15	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
278759	Law Enforcement Officers Safety Act (LEOSA) Photographic Identification Card Application	Form and Instruction	New	Law Enforcement Officers Safety Act (LEOSA) Identification Cards
272308	Law Enforcement Officers Safety Act (LEOSA) Photographic Identification Card Application	Form and Instruction	Unchanged	Law Enforcement Officers Safety Act (LEOSA) Photographic Identification Card Application
248797	Law Enforcement Officers Safety Act (LEOSA) Photographic Identification Card Application	Form and Instruction	Unchanged	Law Enforcement Officers Safety Act (LEOSA) Photographic Identification Card Application

ICR Details

OMB Control No: 1405-0245	ICR Reference No: 202601-1405-008
Status: Received in OIRA	Previous ICR Reference No: 202411-1405-002
Agency/Subagency: STATE/AFA	Agency Tracking No:
Title: RETIRED/FORMER DSS LAW ENFORCEMENT OFFICER LEOSA PHOTOGRAPHIC IDENTIFICATION CARD APPLICATION
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular	Date Submitted to OIRA: 01/15/2026

table that charts list comparision

	Requested	Previously Approved
Expiration Date	36 Months From Approved	02/29/2028
Responses	250	160
Time Burden (Hours)	250	160
Cost Burden (Dollars)	1,758	1,758

---

Abstract: This collection is necessary for DS to process and issue the photographic identification cards (LEOSA Identification Cards) as specified under 18 U.S.C. § 926C (The Law Enforcement Officers Safety Act of 2004 (LEOSA), as amended).

---

Authorizing Statute(s): US Code: 18 USC 926C Name of Law: Carrying of Concealed Firearms by Qualified Retired Law Enforcement Officers
  

Citations for New Statutory Requirements: None

---

Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

---

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	90 FR 12777	08/19/2025
30-day Notice:	Federal Register Citation:	Citation Date:
	91 FR 12898	01/14/2026
Did the Agency receive public comments on this ICR? No

---

Number of Information Collection (IC) in this ICR: 3

table that charts list of burden

IC Title	Form No.	Form Name
Law Enforcement Officers Safety Act (LEOSA) Photographic Identification Card Application	DS-7809	Law Enforcement Officers Safety Act (LEOSA) Photographic Identification Card Application
Law Enforcement Officers Safety Act (LEOSA) Photographic Identification Card Application	DS-7809	Law Enforcement Officers Safety Act (LEOSA) Identification Cards
Law Enforcement Officers Safety Act (LEOSA) Photographic Identification Card Application	DS-7809	Law Enforcement Officers Safety Act (LEOSA) Photographic Identification Card Application

---

ICR Summary of Burden

table that charts list of burden

	Total Request	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	250	160	0	0	90	0
Annual Time Burden (Hours)	250	160	0	0	90	0
Annual Cost Burden (Dollars)	1,758	1,758	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement:

---

Annual Cost to Federal Government: $15,124

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     No

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? No

---

Common Form ICR:  No

---

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 01/15/2026

---