View Information Collection Request (ICR) Package

Please note that the OMB number and expiration date may not have been determined when this Information Collection Request and associated Information Collection forms were submitted to OMB. The approved OMB number and expiration date may be found by clicking on the Notice of Action link below.

View ICR - OIRA Conclusion

OMB Control No: 1652-0039	ICR Reference No: 201811-1652-002
Status: Historical Active	Previous ICR Reference No: 201506-1652-002
Agency/Subagency: DHS/TSA	Agency Tracking No: 1652-0039
Title: TSA Claims Application
Type of Information Collection: Revision of a currently approved collection	Common Form ICR: No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 09/18/2019
	Date Received in OIRA: 01/31/2019
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	09/30/2022	36 Months From Approved	09/30/2019
Responses	11,400	0	10,000
Time Burden (Hours)	5,300	0	5,000
Cost Burden (Dollars)	2,550	0	14,800

ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to Adjustment in Estimate
Annual Number of Responses	11,400	10,000	1,400
Annual Time Burden (Hours)	5,300	5,000	300
Annual Cost Burden (Dollars)	2,550	14,800	-12,250

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: There has been no program change to this collection of information since its previous OMB approval, but the total hours increased from 5,000 to 5,300 due to accounting for payment information requests time and 200 additional claims per year.

Annual Cost to Federal Government: $181,078

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. Yes

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? Uncollected

Agency Contact: Megan Nasir 571 227-1578 megan.nasir@tsa.dhs.gov

Something went wrong when downloading this file. If you have any questions, please send an email to risc@gsa.gov.