TSA Canine Training Center Adoption Application

Forms and Documents

Document Name	Status
Form TSA Form 433 Adoption Application Form and Instruction	New
privacy_pia_tsa_cws.pdf Supplementary Document	2017-06-22
1652-NEW TSA CTC Adoption App SS 8.21.2017.docx Supporting Statement A	2017-08-25
CFR-2016-title41-vol3-sec102-36-365.pdf Supplementary Document	2017-05-23
CFR-2016-title41-vol3-sec102-36-35.pdf Supplementary Document	2017-05-23
SORN dhstsa-006.pdf Supplementary Document	2017-05-23
PLAW-107publ296.pdf Supplementary Document	2017-05-15
PLAW-110publ53.pdf Supplementary Document	2017-05-15
PLAW-107publ71.pdf Supplementary Document	2017-05-15
1652-NEW TSA CTC Adoption App 60DN 81 FR 89963 (12.13.2016).pdf Supplementary Document	2017-05-17
1652-NEW TSA CTC AdoptApp 30DN 82 FR 20909 (5.4.2017).pdf Supplementary Document	2017-05-17

IC Document Collections

IC ID	Document Title	Status
226849	Adoption Application Form and Instruction	New

ICR Details

OMB Control No: 1652-0067	ICR Reference No: 201705-1652-001
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: DHS/TSA	Agency Tracking No:
Title: TSA Canine Training Center Adoption Application
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 08/31/2017
	Date Received in OIRA: 07/06/2017
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	08/31/2020	36 Months From Approved
Responses	300	0	0
Time Burden (Hours)	50	0	0
Cost Burden (Dollars)	25	0	0

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Abstract: The TSA Canine Program is a Congressionally-mandated program that operates pursuant to section 110(e)(3) of the Aviation and Transportation Security Act (ATSA), Pub. L. 107-71 (115 Stat. 597, Nov. 19, 2001); the Homeland Security Act of 2002, Pub. L. 107-296 (116 Stat. 2135, Nov. 25, 2002); and the Implementing Recommendations of the 9/11 Commission Act of 2007, Pub. L. 110-53 (121 Stat. 266, Aug. 3, 2007). The TSA Canine Program developed the TSA CTC to train and deploy explosive detection canine teams to Federal, State, and local agencies in support of daily activities that protect the transportation domain. TSA created the TSA CTC Adoption Program under the authority of 41 CFR 102-36.35(d) and 102–36.365 to find suitable individuals or families to adopt and provide good homes to canines who do not graduate from the training program. Individuals seeking to adopt a TSA canine must complete the TSA CTC Adoption Application. This collection of information allows the TSA CTC to collect personal information from the applicants to determine their suitability to adopt a TSA canine.

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Authorizing Statute(s): PL: Pub.L. 107 - 71 110 Name of Law: Aviation and Transportation Security Act
   PL: Pub.L. 107 - 296 116 Stat. 2135, Nov. 25, 2002 Name of Law: Homeland Security Act of 2002
   PL: Pub.L. 110 - 53 121 Stat. 266, Aug. 3, 2007 Name of Law: Implementing Recommendations of the 9/11 Commission Act of 2007
  

Citations for New Statutory Requirements: None

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

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	81 FR 89963	12/13/2016
30-day Notice:	Federal Register Citation:	Citation Date:
	82 FR 20909	05/04/2017
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
Adoption Application	TSA Form 433	Adoption Application

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ICR Summary of Burden

	Total Approved	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	300	0	0	0	300	0
Annual Time Burden (Hours)	50	0	0	0	50	0
Annual Cost Burden (Dollars)	25	0	0	0	25	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: This is a new collection.

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Annual Cost to Federal Government: $4,747

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.     Yes

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

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Common Form ICR:  No

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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: 07/06/2017

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