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UNCLASSIFIED

TRANSPORTATION SECURITY ADMINISTRATION

TSA PreCheckTM Application Program

PRA Mock Ups (New Enrollment)

Derived from: Multiple Sources; Declassify on: 25x1-human; Date of Source: 20091007

UNCLASSIFIED

TSA PreCheck Enrollment and Renewal Tree
TSA PreCheck Enrollment and Renewal Tree

Please select whether you want to enroll in the TSA PreCheck Application Program or renew in the TSA PreCheck Application Program

New Enrollment

Renewal

Notice of Eligibility

Known Traveler Number Query

Biographic Information

Notice of Eligibility

Citizenship

Address Information Updates

Attributes

Contact Information Updates

Address Information

Documents Updates

Contact Information

Attestation

Documents

Payment

Attestation

Post Renewal Survey

Biometrics*
Payment
Post Enrollment Survey*
* All Items except Biometrics and the Post
Enrollment Survey may be done in a pre-enrollment
option online.

All renewal items may be done online unless you
have had a change in biographic information (name
change) or have been informed you must submit
additional biometrics

* All screenshots are examples only and actual enrollment screens may differ between TSA PreCheck enrollment providers.

2

TSA PreCheck Enrollment Start
START
Notice of
Eligibility
Questions

TSA PreCheck Enrollment Start

Biographic
Information

Citizenship

Thank you for choosing to enroll in the TSA PreCheck Application Program!

Attributes

Address
Information

Contact
Information

Documents

Attestation

Biometrics
Payment
Post
Enrollment
Survey
FINISH

* All screenshots are examples only and actual enrollment screens may differ between TSA PreCheck enrollment providers.

3

TSA PreCheck Privacy Act

PRIVACY ACT STATEMENT
Authority: 6 U.S.C. § 1140, 46 U.S.C. § 70105; 49 U.S.C. §§ 106, 114, 5103a, 40103(b)(3), 40113, 44903, 44935-44936, 44939, and 46105; the Implementing
Recommendations of the 9/11 Commission Act of 2007, § 1520 (121 Stat. 444, Public Law 110-52, August 3, 2007); and Executive Order 9397, as amended.
Purpose: The Department of Homeland Security (DHS) will use your information to conduct a security threat assessment. Biometrics collected from applicants
to the TSA PreCheck™ Application Program may also be used to conduct screening at airport checkpoints. Your fingerprints and associated information will be
provided to the Federal Bureau of Investigation (FBI) for the purpose of comparing your fingerprints to other fingerprints in the FBI’s Next Generation
Identification (NGI) system or its successor systems including civil, criminal, and latent fingerprint repositories. The FBI may retain your fingerprints and
associated information in NGI after the completion of this application and, while retained, your fingerprints may continue to be compared against other
fingerprints submitted to or retained by NGI. DHS will also transmit your fingerprints for enrollment into Automated Biometrics Identification System (IDENT). If
you provide your Social Security Number (SSN), DHS may provide your name and SSN to the Social Security Administration (SSA) to compare that information
against SSA records to ensure the validity of the information.
Routine Uses: This system may disclose information in accordance with the Privacy Act, 5 U.S.C. 552a(b), including as a routine use pursuant to 5 U.S.C. 552a(b)
(3) with third parties during the course of a security threat assessment, employment investigation, or adjudication of a waiver or appeal request to the extent
necessary to obtain information pertinent to the assessment, investigation, or adjudication of your application under the TSA system of records notice (SORN)
DHS/TSA 002, Transportation Security Threat Assessment System, or DHS/TSA 021, TSA PreCheck Application Program for applicants to that program.
Disqualifying criminal offenses uncovered during your application limit your ability to access TSA PreCheck expedited screening. For as long as your fingerprints
and associated information are retained in NGI, your information may be disclosed pursuant to your consent or without your consent as permitted by the
Privacy Act of 1974 and all applicable Routine Uses as may be published at any time in the Federal Register, including the Routine Uses for the NGI system and
the FBI’s Blanket Routine Uses.
Disclosure: Furnishing this information (including your SSN) is voluntary; however, if you do not provide your SSN or any other information requested, DHS may
be unable to complete your application for a security threat assessment.

* All screenshots are examples only and actual enrollment screens may differ between TSA PreCheck enrollment providers.

4

TSA PreCheck Paperwork Reduction Act

PAPERWORK REDUCTION ACT STATEMENT:
Statement of Public Burden: This is a voluntary collection of information, but failure to provide the
information may result in an inability to approve your eligibility for the requested TSA program or
benefit. TSA estimates that the total average burden per response associated with this collection for
enrollment is approximately 30 minutes. An agency may not conduct or sponsor, and a person is not
required to respond to, a collection of information unless it displays a valid OMB control number. The
control number for this collection is OMB 1652-0059, which expires Month XX, 20XX. Send
comments regarding our estimate or any other aspect of this collection, including suggestions
for reducing burden, to DHS/TSA, [email protected] or TSA-11, Transportation Security
Administration, 6595 Springfield Center Drive, Springfield, Virginia 20598-6011. Attn: PRA
1652-0059 TSA PreCheck Application.

* All screenshots are examples only and actual enrollment screens may differ between TSA PreCheck enrollment providers.

5

TSA PreCheck Notice of Eligibility Questions
Applicant Eligibility Questions

START
Notice of
Eligibility
Questions
Biographic
Information

Citizenship

1. Are you a U.S. Citizen, U.S. National or Lawful Permanent Resident?

YES

NO

YES

NO

YES

NO

YES

NO

5. Are you wanted or under indictment for any disqualifying crime listed in
TSA Eligibility Requirements, Parts A or B?

YES

NO

6. Have you ever been found by a court or other lawful authority as lacking mental
capacity or involuntarily committed to a mental institution?

YES

NO

2. Excluding juvenile cases unless convicted as an adult, have you been convicted,
pled guilty including “no contest” (nolo contendere), or found not guilty by reason
of insanity, of any disqualifying felony listed in TSA Eligibility Requirements, Part A,
in any jurisdiction, military or civilian?

Attributes

Address
Information

Contact
Information

Documents

Attestation

Biometrics
Payment
Post
Enrollment
Survey

3. Excluding juvenile cases unless convicted as an adult, have you been convicted,
pled guilty including “no contest” (nolo contendere), or found not guilty by reason
of insanity, of any disqualifying felony listed in TSA Eligibility Requirements, Part B,
in any jurisdiction, military or civilian, during the 7 years before the date of this
application?
4. Have you been released from incarceration in any jurisdiction, military or civilian,
for committing any disqualifying felony listed in TSA Eligibility Requirements, Part B,
during the 5 years before the date of this application?

FINISH

* All screenshots are examples only and actual enrollment screens may differ between TSA PreCheck enrollment providers.

6

TSA PreCheck Applicant Information (Biographic)
START
Notice of
Eligibility
Questions

Applicant Biographic Information
Your legal name must match your identification documents

Biographic
Information

* First Name:

Citizenship

* Middle Name (or NMN if no middle name):

Attributes

* Last Name:

Address
Information

Contact
Information

Documents

Attestation

Suffix: Choose One
* Gender: Choose One
* Date of Birth (MM/DD/YYYY):

Biometrics
Payment
Post
Enrollment
Survey
FINISH

1. * Have you ever used a maiden/previous name
2. * Have you ever used an alias?

YES

NO

YES

NO

All fields marked with * are required fields

* All screenshots are examples only and actual enrollment screens may differ between TSA PreCheck enrollment providers.

7

TSA PreCheck Applicant Information (Biographic)
START

Applicant Biographic Information

Notice of
Eligibility
Questions
Biographic
Information

You must provide all maiden/previous names

* First Name:

Citizenship

Attributes

Address
Information

Contact
Information

* Middle Name (or NMN if no middle name):
* Last Name:
Suffix: Choose One

Documents

Attestation

Biometrics
Payment

Have you used any other additional maiden/previous names?

YES

NO

Post
Enrollment
Survey
FINISH

All fields marked with * are required fields

* All screenshots are examples only and actual enrollment screens may differ between TSA PreCheck enrollment providers.

8

TSA PreCheck Applicant Information (Biographic)
START

Applicant Biographic Information

Notice of
Eligibility
Questions
Biographic
Information

You must provide all aliases

* First Name:

Citizenship

* Middle Name (or NMN if no middle name):
Address
Information

Contact
Information

* Last Name:
Suffix: Choose One

Documents

Attestation

Biometrics
Payment

Have you used any other additional aliases?

YES

NO

Post
Enrollment
Survey
FINISH

All fields marked with * are required fields

* All screenshots are examples only and actual enrollment screens may differ between TSA PreCheck enrollment providers.

9

TSA PreCheck Citizenship
START
Notice of
Eligibility
Questions
Biographic
Information

Applicant Citizenship Information
Only U.S. citizens, U.S. Nationals and Lawful Permanent Residents (LPR)
are eligible to apply.

*
* Country of Birth: Choose One

Citizenship

Attributes

Address
Information

* City of Birth:

Contact
Information

* Country of Citizenship: Choose One

Documents

Are you a Lawful Permanent Resident of the US?

Attestation

Biometrics
Payment
Post
Enrollment
Survey
FINISH

State of Birth:

YES

NO

Non US Citizens Only

Please review the “US Citizenship, U.S. National, or Lawful
Permanent Resident Proving Documents” you shall provide for this
enrollment. Click this link for list of acceptable documents with
descriptions.
All fields marked with * are required fields

* All screenshots are examples only and actual enrollment screens may differ between TSA PreCheck enrollment providers.

10

TSA PreCheck Attributes
START
Notice of
Eligibility
Questions

Applicant Physical Attributes

Biographic
Information

Citizenship

* Height: Feet

ft

Inches

in

Attributes

Address
Information

Contact
Information

* Weight (lbs): Pounds
* Hair Color: Choose One

Documents

Attestation

* Eye Color: Choose One

Biometrics
Payment
Post
Enrollment
Survey

All fields marked with * are required fields

FINISH

* All screenshots are examples only and actual enrollment screens may differ between TSA PreCheck enrollment providers.

11

TSA PreCheck Address Information
START

Applicant Address Information

Notice of
Eligibility
Questions
Biographic
Information

Citizenship

1. * Is your mailing address the same as your residential address?

YES

NO

YES
NO
2. * Have you lived at your current residential address for more than five (5) years?

Attributes

Residential Address

Address
Information

Contact
Information

Documents

Attestation

Biometrics

* Country: Choose One
* Address Line 1:
Address Line 2:
* City:

Payment
Post
Enrollment
Survey
FINISH

* State/Province:

* Postal Code:
All fields marked with * are required fields

* All screenshots are examples only and actual enrollment screens may differ between TSA PreCheck enrollment providers.

12

TSA PreCheck Address Information
START
Notice of
Eligibility
Questions

Applicant Address Information

Biographic
Information

Citizenship

Previous Residential Address
* Country: Choose One

Attributes

Address
Information

Contact
Information

Documents

Attestation

* Address Line 1:
Address Line 2:
* City:
* State/Province:

* Postal Code:

Biometrics
Payment
Post
Enrollment
Survey
FINISH

All fields marked with * are required fields

* All screenshots are examples only and actual enrollment screens may differ between TSA PreCheck enrollment providers.

13

TSA PreCheck Address Information
START
Notice of
Eligibility
Questions

Applicant Address Information

Biographic
Information

Mailing Address

Citizenship

Attributes

Address
Information

Contact
Information

Documents

* Country: Choose One
* Address Line 1:
Address Line 2:
* City:

Attestation

Biometrics

* State/Province:

* Postal Code:

Payment
Post
Enrollment
Survey
FINISH

All fields marked with * are required fields

* All screenshots are examples only and actual enrollment screens may differ between TSA PreCheck enrollment providers.

14

TSA PreCheck Contact Information
START
Notice of
Eligibility
Questions
Biographic
Information

Applicant Contact Information
You must choose at least one method of contact. Please select yes or no to
opt-in to receiving important TSA PreCheck updates via email or phone.

Citizenship

Attributes

Address
Information

Contact
Information

Email 1:

YES

NO

Email 2:

YES

NO

Phone 1:

* Text Messaging:

YES

NO

YES

NO

Attestation

Phone 2:

* Text Messaging:

YES

NO

YES

NO

Biometrics

* Please select yes or no to opt-in to receive important updates and other TSA PreCheck information
via text messaging. Text messaging rates may apply

Documents

Payment
Post
Enrollment
Survey
FINISH

All fields marked with * are required fields

* All screenshots are examples only and actual enrollment screens may differ between TSA PreCheck enrollment providers.

15

TSA PreCheck Documents
START
Notice of
Eligibility
Questions
Biographic
Information

Applicant Document Information
Your legal name must match your identification documents. Documents
may be uploaded during pre-enrollment or during in-person enrollment.
However, you must present a government issued ID during in-person
enrollment regardless of documents uploaded during pre-enrollment.

Citizenship

Attributes

Address
Information

Contact
Information

Please select the “Citizenship and Identity Proving Documents” you
shall provide for this enrollment. Click this link for list of acceptable
documents with descriptions.
* Photo ID: Choose One

Documents

Attestation

Biometrics
Payment

Does this document match your legal name:

YES

NO

If you select no you must provide all additional name linking documents below.

Citizenship/Immigration Document: Choose all that apply
Upload Documents

Post
Enrollment
Survey
FINISH

All fields marked with * are required fields

* All screenshots are examples only and actual enrollment screens may differ between TSA PreCheck enrollment providers.

16

TSA PreCheck Attestation
START
Notice of
Eligibility
Questions

Attestation

Biographic
Information

Citizenship

Attributes

Address
Information

Contact
Information

Documents

Attestation

 I understand my continuing obligation to notify TSA within 24 hours if I am
convicted or found not guilty by reason of insanity of any disqualifying crime, or
adjudicated as a mental defective or committed to a mental institution, while I
am enrolled in the TSA PreCheck Application Program.
 The Information I provided on this application is true, complete, and correct to
the best of my knowledge and belief and is provided in good faith. I
understand that a knowing and willful false statement, or an omission of a
material fact can be punished by fine or imprisonment or both (see section
1001 of Title 18 United States Code), and may be grounds for denial of my
application for the TSA PreCheck Application Program by TSA.

Biometrics
Payment

Please check each block above acknowledging you have read the statements and agree to all terms and
conditions of the TSA PreCheck Application Program

Post
Enrollment
Survey
FINISH

* All screenshots are examples only and actual enrollment screens may differ between TSA PreCheck enrollment providers.

17

TSA PreCheck Biometric Collections
START
Notice of
Eligibility
Questions
Biographic
Information

Applicant Biometric Collections
For the in-person fingerprint collection, TSA has procedures to
accommodate individuals who are partial or full amputees or who may be
unable to provide ten fingerprints.

Citizenship

Fingerprint Scans

Attributes

Address
Information

Contact
Information

Documents

Attestation

Biometrics
Payment
Post
Enrollment
Survey

Left Hand

Right Hand

FINISH

* All screenshots are examples only and actual enrollment screens may differ between TSA PreCheck enrollment providers.

18

TSA PreCheck Biometric Collections
START
Notice of
Eligibility
Questions

Applicant Biometric Collections

Biographic
Information

Citizenship

Attributes

Address
Information

Contact
Information

Documents

Attestation

Biometrics
Payment

Facial Image

Post
Enrollment
Survey
FINISH

* All screenshots are examples only and actual enrollment screens may differ between TSA PreCheck enrollment providers.

19

TSA PreCheck Payment
START

Payment

Notice of
Eligibility
Questions
Biographic
Information

Citizenship

Attributes

Address
Information

Contact
Information

Documents

Please select the payment method for your TSA PreCheck
Application Payment:
Choose One
Please enter a TSA PreCheck coupon or promotion code:

Attestation

Biometrics

Pay

Payment
Post
Enrollment
Survey
FINISH

All fields marked with * are required fields

* All screenshots are examples only and actual enrollment screens may differ between TSA PreCheck enrollment providers.

20

TSA PreCheck Post Enrollment Survey
START
Notice of
Eligibility
Questions

Post Enrollment Survey
Do you want to participate in this optional survey?YES

NO

Biographic
Information

Citizenship

Attributes

Address
Information

Contact
Information

Documents

Attestation

Biometrics
Payment
Post
Enrollment
Survey

1. How satisfied are you with your overall enrollment experience?
o Very satisfied
o Satisfied
o Neither satisfied or dissatisfied
o Dissatisfied
o Very dissatisfied
2. If you experienced an issue that required a resolution, how satisfied are
you with the resolution?
o Very satisfied
o Satisfied
o Neither satisfied or dissatisfied
o Dissatisfied
o Very dissatisfied
o N/A

FINISH

* All screenshots are examples only and actual enrollment screens may differ between TSA PreCheck enrollment providers.

21

TSA PreCheck Post Enrollment Survey
START
Notice of
Eligibility
Questions

Post Enrollment Survey

Biographic
Information

Citizenship

Attributes

Address
Information

Contact
Information

Documents

Attestation

3. Did the enrollment representative(s) conduct themselves in a
professional and courteous manner?
o Yes
o No
4. How satisfied are you with the enrollment location and appearance?
o Very satisfied
o Satisfied
o Neither satisfied or dissatisfied
o Dissatisfied
o Very dissatisfied

Biometrics
Payment
Post
Enrollment
Survey
FINISH

* All screenshots are examples only and actual enrollment screens may differ between TSA PreCheck enrollment providers.

22

TSA PreCheck Post Enrollment Survey
START
Notice of
Eligibility
Questions

Post Enrollment Survey

Biographic
Information

Citizenship

Attributes

Address
Information

Contact
Information

Documents

Attestation

Biometrics

5. How did you first learn about TSA PreCheck?
o Signage at the airport
o Family Member/Friend
o Co-Worker/Employer
o News Outlet (stories in digital, radio, TV, etc.)
o Advertisement (digital, social media ads, radio, video, billboards,
etc.)
o Government Website
o Other Internet Site
o Credit Card/Loyalty Program
o Another TSA PreCheck Member
o Other (Please specify):

Payment
Post
Enrollment
Survey
FINISH

* All screenshots are examples only and actual enrollment screens may differ between TSA PreCheck enrollment providers.

23

TSA PreCheck Post Enrollment Survey
START
Notice of
Eligibility
Questions
Biographic
Information

Citizenship

Attributes

Address
Information

Contact
Information

Post Enrollment Survey
6. What were the most important factors in your decision to enroll in TSA
PreCheck? (Please check all that apply.)
o Saves me time at the airport
o Easier, more efficient screening process (no need to remove
shoes, belts, liquids, electronics)
o Relieves stress associated with security screening
o Ease of enrollment compared to Global Entry or other Trusted
Traveler Programs
o Travel companions/co-workers are members
o Other (please specify):

Documents

Attestation

Biometrics
Payment
Post
Enrollment
Survey

7. Please complete the following: For the value, the cost of TSA PreCheck
enrollment is…
o Too expensive
o Somewhat expensive
o A good value
o Somewhat inexpensive
o Too inexpensive

FINISH

* All screenshots are examples only and actual enrollment screens may differ between TSA PreCheck enrollment providers.

24

TSA PreCheck Post Enrollment Survey
START
Notice of
Eligibility
Questions
Biographic
Information

Citizenship

Attributes

Address
Information

Contact
Information

Documents

Attestation

Biometrics
Payment

Post Enrollment Survey
8. Please estimate the total amount of time you spent on the TSA PreCheck
enrollment process including filling out the online enrollment application,
traveling to and from the enrollment location, and time spent at the
enrollment location:
o Less than 30 minutes
o 30-60 minutes
o 60-90 minutes
o More than 90 minutes
9. How did you pay for your TSA PreCheck application fee?
o Paid myself
o Used points/miles with a participating loyalty program provider
o Used a credit card that reimburses enrollment fees
o Company / employer will reimburse enrollment fees
o Other – please specify:

Post
Enrollment
Survey
FINISH

* All screenshots are examples only and actual enrollment screens may differ between TSA PreCheck enrollment providers.

25

TSA PreCheck Post Enrollment Survey
START
Notice of
Eligibility
Questions
Biographic
Information

Citizenship

Attributes

Address
Information

Contact
Information

Documents

Attestation

Biometrics
Payment

Post Enrollment Survey
10. Having completed TSA PreCheck enrollment, how likely are you to
recommend signing up to others?
o Highly likely
o Somewhat likely
o Neutral
o Somewhat unlikely
o Highly unlikely
11. In the past year, how many trips, if any, have you taken that included air
travel? One trip is defined as the period from when you leave home to
when you return home. If a trip included multiple destinations, please
count that as only one trip. Please provide your best estimate for each
type.
• Leisure travel/travel for pleasure:
• Business travel:

Post
Enrollment
Survey
FINISH

* All screenshots are examples only and actual enrollment screens may differ between TSA PreCheck enrollment providers.

26

TSA PreCheck Post Enrollment Survey
START

Post Enrollment Survey

Notice of
Eligibility
Questions
Biographic
Information

Citizenship

12. How far in advance do you typically book your flights? Please select one
response for leisure travel and one response for business travel.
Leisure

Attributes

Address
Information

Contact
Information

Documents

Attestation

•
•
•
•
•
•
•
•
•

Business

The week of the travel
2 to 3 weeks
4 to 5 weeks
6 to 7 weeks
2 months
3 to 4 months
5 or more months
Unsure/I don’t know
Not Applicable

Biometrics
Payment
Post
Enrollment
Survey
FINISH

* All screenshots are examples only and actual enrollment screens may differ between TSA PreCheck enrollment providers.

27

TSA PreCheck Post Enrollment Survey
START
Notice of
Eligibility
Questions
Biographic
Information

Citizenship

Post Enrollment Survey

13. If you have any additional feedback about your experience that you
would like to provide, please provide it here.

Attributes

Address
Information

Free Text

Contact
Information

Documents

Attestation

Biometrics

SUBMIT

Payment
Post
Enrollment
Survey
FINISH

* All screenshots are examples only and actual enrollment screens may differ between TSA PreCheck enrollment providers.

28

TSA PreCheck Enrollment Finish
START
Notice of
Eligibility
Questions

Enrollment Finish

Biographic
Information

Citizenship

Thank you for enrolling in the TSA PreCheck Application Program!

Attributes

Address
Information

Contact
Information

Documents

Attestation

Biometrics
Payment
Post
Enrollment
Survey
FINISH

* All screenshots are examples only and actual enrollment screens may differ between TSA PreCheck enrollment providers.

29