Form TSA Form 424 TSA Form 424 Screening Partnership Program Application

OMB control number 1652-0064
Exp. 11/30/2021

DEPARTMENT OF HOMELAND SECURITY
Transportation Security Administration
SCREENING PARTNERSHIP PROGRAM APPLICATION
INSTRUCTIONS: Complete a separate application for each airport. An authorized representative of the airport or the airport owner must
complete the application. The application must be completed in full to be considered for approval by TSA. Attach all supporting documentation
to the application and use separate sheets if more detail is needed. Please provide a copy of the completed application to the Federal Security
Director.

SECTION I. Airport Information
Request Date

Airport Name

FAA Identifier

Airport Operating Authority
SECTION II. Contact Information
Authorized Requestor
Primary Number

Position
Alternate Phone Number

Mailing Address

Email Address
Email Address

SECTION III. Required Information
1. Indicate if the requesting airport authority seeks to provide or may seek to provide the private security screening services
at the airport. Airports interested in providing their own private security screening services must submit a proposal (per
instructions posted on FedBizOpps.gov) and compete for contract award in accordance with the Competition in
Contracting Act and the Federal Acquisition Regulation.
a.

YES

b.

NO

2. Does the airport have any activities planned within the next 18 months, such as major construction or significant
volume adjustments that would affect the screening operation?
a.

YES

b.

NO

Section IV. Optional Information
3. Provide any additional information you would like TSA to consider during the evaluation of this application. Additional pages
may be attached.

Previous editions of this form are obsolete.
TSA Form 424 (9/19) rev. [File: 400.21.1]

Page 1 of 2

Section V. Signature
Upon execution of this application, the authorized representative, (specified as the primary point of contact in this document)
hereby requests the TSA Administrator to approve this application to have the screening of passengers and property at the airport
conducted by a privatized screening company contracted to the TSA, as provided for under Section 44901 of the Aviation and
Transportation Security Act, as amended.
TSA will evaluate this application in accordance with the criteria specified in section 44920, as amended, of Title 49, United States
Code. If the application is approved, the airport operator understands that any potential contract resulting from the submission of
this application will be awarded and administered by TSA in accordance with the Competition in Contracting Act and the Federal
Acquisition Regulation.

Signature

Date of Execution (Application Date)

Print Name
PAPERWORK REDUCTION ACT BURDEN STATEMENT: TSA’s Screening Partnership Program (SPP) (49 U.S.C. § 44920 (ATSA
§108)) enables commercial airports to apply for a private screening company to provide passenger and baggage security screening
services. Transportation Security Administration estimates that the average burden for collection is 5 minutes per response. This is a
voluntary collection of information. You may submit any comments concerning the accuracy of this burden estimate or any suggestions
for reducing the burden to: TSA-11, Attention: PRA 1652-0034 601 South 12th Street, Arlington, VA 20598. 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 assigned to this collection is OMB No. 1652-0064, which expires 11/30/2021.

Previous editions of this form are obsolete.
TSA Form 424 (9/19) rev. [File: 400.21.1]

Page 2 of 2