Information Collection

STA Applications

IC 189823 under ICR 201002-1652-003 · OMB 1652-0053.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1652-0053 can be found here:

Documents and Forms

Document Name Document Type
Form TSA Form Number 41 STA Applications Form and Instruction
TSA Form Number 41 Security Threat Assessment Application TSA_Form_419F_STA_Application.doc Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	STA Applications	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 49 CFR 1549.11 49 CFR 1549.103 49 CFR 1522.117 49 CFR 1522.121

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	TSA Form Number 419F	Security Threat Assessment Application	TSA_Form_419F_STA_Application.doc		No		Fillable Printable

Line of Business: Homeland Security

Subfunction: Border and Transportation Security

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 313,164	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	313,164	731	312,433
Annual IC Time Burden (Hours)	78,291	183	78,108
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.