Security Threat Assessment for Individuals Applying for a Hazardous Materials Endorsement for a Commercial Driver's License

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Security Threat Assessment for Individuals Applying for a Hazardous Materials Endorsement for a Commercial Driver's License

OMB: 1652-0027

⚠️ Notice: This form may be outdated. More recent filings and information on OMB 1652-0027 can be found here:

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Welcome to the Universal Enrollment Services (UES) website, providing enrollment
services for the Transportation Security Administration (TSA).
Important Notices

08/05/13 Labor Day holiday closure information See All Important Notices >

Select a program below to see a list of available services and information:

HazMat

Check Status

Locate an Enrollment Center

Check the status of your service.

Locate and get directions to an enrollment
center near you.

The use of the HME, HAZMAT, TSA Pre3™, TWIC®, and Universal Enrollment Services (UES) names in connection with this website is with the
express permission of the Department of Homeland Security, Transportation Security Administration

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FAQ

Welcome to the Universal Enrollment Services (UES) website, providing enrollment
services for the Transportation Security Administration (TSA).
Important Notices

08/05/13 Labor Day holiday closure information See All Important Notices >

Select a p
program
g
below to see a list of available services and information:

HazMat

Select A Service
Pre-Enroll
Enter enrollment information online, schedule an enrollment appointment.

Schedule an Appointment
Schedule an in-person appointment or change an existing appointment.

What do I need to bring to enrollment?
Find out which documents you need to bring to the enrollment center to facilitate processing.
For U.S. Citizens | For non-U.S. Citizens

Driver

License

PASSPO
P
ASS RT
T

Check Status

Locate an Enrollment Center

Check the status of your service.

Locate and get directions to an enrollment
center near you.

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Hazardous Materials Endorsement (HME) Pre-Enroll
Enter Information

Step 1 of 7
* Required fields

Please enter your information below. Then click ‘Next’ to continue.
Legal Name must match exactly on all identification documents brought to enrollment.
Legal Name
*First Name

*Middle Name (or NMN if no middle name)

John

Steven

*Last Name

Suffix

Smith
*Gender

*Date of Birth (MM/DD/YYYY)

Male

12/30/1972

*Method of Contact
Country Code
United States (+1)
Country Code

United States (+1)

Preferred Language

English

Phone 1

615-123-4567
Phone 2

615-123-4567

jsmith@comcast.net
*Preferred Method of Contact

Phone 1

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PRIVACY ACT STATEMENT:
Authority: The authority for collecting this information is 49 U.S.C. 114, 114note, and 5103a.
Principal Purpose(s): This information is needed to verify your identity and to conduct a security threat assessment to
evaluate your suitability for the Hazardous Materials Endorsement Threat Assessment Program. Furnishing this
information, including your SSN or alien registration number, is voluntary; however, all information provided during the
enrollment process assists in the timely processing of your security threat assessment. Failure to provide it will delay and
may prevent completion of your security threat assessment..
Routine Uses: Routine uses of this information include disclosure to the FBI to retrieve your criminal history record; to TSA
contractors or other agents who are providing services relating to the security threat assessments; to appropriate
governmental agencies for licensing, law enforcement, or security purposes, or in the interests of national security; and to
foreign and international governmental authorities in accordance with law and international agreement.

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 1652-0027.

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Hazardous Materials Endorsement (HME) Pre-Enroll

Step 2 of 7

Determine Citizenship

* Required fields

*Country of Birth

United States
*City of Birth

Nashville
*State/Province of Birth

Tennessee
*Country of Citizenship

United States

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Hazardous Materials Endorsement (HME) Pre-Enroll

step 3 of 7

Answer Personal Questions

* Required fields

* Have you ever used a maiden/previous name?
Yes

* Have you ever used an alias?

Yes

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

Yes

* Have you lived at your current residential address for more than five (5) years?

Yes

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Hazardous Materials Endorsement (HME) Pre-Enroll

step 4 of 7

Enter Personal Information

* Required fields

*Alias
*First Name

Middle Name

Jimmy

John

*Last Name

Suffix

Smith
US

Metric

*Weight

*Height
6

205

*Hair Color

*Eye Color

Brown

Multi-color

lbs

*Are you transferring a current Commercial Driver’s License (CDL)?
Yes

*Commercial Driver License Number

00123456

*State of Issuance

South Dakota

Prior CDL information

*Commercial Driver License Number

*State/Province of Issuance

65465412

Tennessee

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Hazardous Materials Endorsement (HME) Pre-Enroll

Step 5 of 7

Enter Address

* Required fields

*Mailing Address
*Country
United States
*Address Line 1
15 Century Blvd
Address Line 2

Suite 110
*City
Nashville
*State/Province

*Postal Code

Tennessee

37214 - 0129

*Residential Address
*Country
United States
*Address Line 1
123 Elm Hill Pike
Address Line 2

*City
Nashville
*State/Province

*Postal Code

Tennessee

37214 - 0129

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Hazardous Materials Endorsement (HME) Pre-Enroll

Step 6 of 7

Answer Disclosure Questions

* Required fields

If you answer ‘Yes’ to question 5, because you are currently under indictment or have open criminal charges,
you should consider waiting to apply until these matters are resolved as enrollment fees are not refunded.
1. *Are you a U.S. citizen?

Yes

2. *Excluding juvenile cases unless convicted as an adult, have you been convicted, pled guilty including “no contest”, or
found not guilty by reason of insanity, of any disqualifying felony listed in 49 CFR 1572.103 (Section VII, Part A), in any
jurisdiction, military or civilian?

Yes

3. *Excluding juvenile cases unless convicted as an adult, have you been convicted, pled guilty including “no contest”, or
found not guilty by reason of insanity, of any disqualifying felony listed in 49 CFR 1572.103 (Section VII, Part B), in any
jurisdiction, military or civilian, during the 7 years before the date of this application?

Yes

4. *Have you been released from incarceration in any jurisdiction, military or civilian, for committing any disqualifying felony
listed in 49 CFR 1572.103 (Section VII, Part B), during the 5 years before the date of this application?

Yes

5. *Are you wanted or under indictment for any disqualifying crime listed in listed in 49 CFR 1572.103 (Section VII, Parts A
and B)?

Yes

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

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Hazardous Materials Endorsement (HME) Pre-Enroll

Step 7 of 7

Select Appointment Location
Enter a Postal Code or City to find a location to schedule your appointment.

37214
Narrow search by program:

HazMat

Select the location row. Then click ‘Next’ to continue.

Nashville, TN
15 Century Blvd.
Suite 500
Nashville, TN

1.7 mi

Hours:
Mon & Wed & Thur: 9:00AM - 12:00PM & 1:00PM - 4:00PM
Tues & Fri: 9:00AM - 12:00PM & 1:00PM - 2:00PM
Note: Ample tractor-trailer parking is available in a lot and on the east side of
Century Blvd. at the dead end of the street. The Enrollment Center is located at
15 Century Blvd, on the 5th floor, in the office of MorphoTrust USA. Building II is
marked on the exterior stone sign, with MorphoTrust USA. The inside lobby
marquee lists the Enrollment Center in Suite 500.
View Map

Chattanooga, TN
6102 Shallowford Road
Ste. 102
Chattanooga, TN

HazMat

113.6 mi

Hours:
Mon - Fri: 9:00AM - 12:00PM & 12:30PM - 3:00PM
Note: Tractor-trailer parking is available for up to six trucks at a public parking
lot located at the corner of Broadway Street and 7th Street (1/2 block from the
Enrollment Center).
The Paducah Enrollment Center Hours of Operation will change effective July 15,
2013, to Mon - Fri: 8:30AM - 12:00PM & 1:00PM - 3:00PM.
View Map

Decatur, AL
1436 Shoal Creek Road
Decatur, AL

HazMat

115.2 mi

Hours:
Mon - Fri: 8:30AM - 4:30PM
Note: Tractor-trailer parking is available on south side of building and in the rear.
The Enrollment Center is off TN-153.
View Map

Paducah, KY
611 Broadway Street
Paducah, KY

HazMat

124.7 mi

Hours:
Mon - Fri: 8:30AM - 12:00PM & 1:00PM - 3:00PM
Note: Tractor-trailer parking is available for up to six trucks at a public parking lot located
at the corner of Broadway Street and 7th Street (1/2 block from the Enrollment Center).
View Map

Evansville, IN
2532 Waterbridge Way
Evansville, IN

HazMat

136.1 mi

Hours:
Mon, Tues, Thur & Fri: 8:30AM - 11:30AM
Wed: 8:30AM - 11:30AM & 1:30PM - 4:30PM
Note: There is truck parking available on 1st Ave. in a large vacant shopping strip parking l
ot between Colorado Ave. and Landbridge Way. There is also parking available behind
Grandy's on Landbridge Way. Tractor-trailer trucks CANNOT drive on Colorado Ave., so
please use Landbridge Way to approach the facility or park in the shopping center across
1st Ave. and walk across the street to the facility.
View Map

Walk-In

HazMat

Note: scheduled appointments take priority over walk-ins

Without Scheduling
Appointment

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Hazardous Materials Endorsement (HME) Pre-Enroll

Step 7 of 7

Select Date and Time
Select a preferred date and time for your appointment at the specified location. Then click ‘Submit’ to confirm.
Appointment Date and Time

*Select Date

*Select Time

Monday, July 22, 2013

12:15 PM

Nashville, TN
15 Century Blvd.
Suite 500
Nashville, TN

Hours:
Mon & Wed & Thur: 9:00AM - 12:00PM & 1:00PM - 4:00PM
Tues & Fri: 9:00AM - 12:00PM & 1:00PM - 2:00PM

1.7 mi

Note: Ample tractor-trailer parking is available in a lot and on the east side of
Century Blvd. at the dead end of the street. The Enrollment Center is located at
15 Century Blvd, on the 5th floor, in the office of MorphoTrust USA. Building II is
marked on the exterior stone sign, with MorphoTrust USA. The inside lobby
marquee lists the Enrollment Center in Suite 500.
View Map

Back

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Service Status
HME

TWIC

Thank you for Pre-Enrolling! Your transaction summary is below.

Print Status

Note: Enrollment must be completed within one year of pre-enrollment date.
Service Details:

Date:
UE ID:
Applicant:
Service:

07/05/13 @ 11:03 AM
U11F-193H9F
JOHN S SMITH
HAZARDOUS MATERIALS ENDORSEMENT (HME) ENROLL

Important!
YOU WILL BE REQUIRED TO BRING IDENTIFICATION DOCUMENTATION TO YOUR ENROLLMENT.
Legal Name must match exactly on all identification documents brought to enrollment.
Click here for a list of required documents>

Status as of 07/05/13:

Pre-Enrolled
You have successfully pre-enrolled. Please visit an enrollment center within one year to complete your enrollment.

HAZARDOUS MATERIALS ENDORSEMENT (HME) ENROLL Appointment Details:

Nashville, TN

Appointment Time: 07/22/13 @ 12:15 PM CST

15 Century Blvd.
Suite 500
Nashville, TN

Note: Ample tractor-trailer parking is available in a lot and on the east side of Century Blvd.
at the dead end of the street. The Enrollment Center is located at 15 Century Blvd, on the
5th floor, in the office of MorphoTrust USA. Building II is marked on the exterior stone sign,
with MorphoTrust USA. The inside lobby marquee lists the Enrollment Center in Suite 500.
View Map

1.7 mi

Please provide 24 hours’ notice when cancelling/rescheduling an appointment.
To reschedule an appointment, you must first cancel your existing appointment.

Cancel Appointment

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File Type	application/pdf
File Title	HME_web_compsite.pdf
Author	klesuer
File Modified	2013-08-21
File Created	2013-08-21