Critical Facilities-CFSR _ Follow -Up

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Overview

SSI Cover Sheet
Profile
6-Month CFSR Follow-up Form
12-Month CFSR Follow-up Form
18-Month CFSR Follow-up Form
Summary
PRA Burden

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Sheet 1: SSI Cover Sheet

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Sheet 2: Profile

DEPARTMENT OF HOMELAND SECURITY

Transportation Security Administration

Pipeline Critical Facility Security Review (CFSR) Follow-up Form

CFSR FUF FY2021 V.2 (December 2020)

Report Date

TSA Field Office

Region #

10/1/2020

Please enter the 3-letter airport code of your field office assignment.

TSA Region #1-5

Dates Encompassed

Virtual?

TYPE OF VISIT

Critical Facility Security Review Follow-up

Corporate / Operator Information

<<< Corporate / Operator Name Here >>>

Address

City

State

Zip

Total Number of Recommendations:

0

Facilities Followed Up on This Form

Facility #

CFSR Date

Facility Name

Address

City

State

Zip

1

2

3

4

5

6

7

8

9

10

Security Personnel Interviewed

Name

Title

Telephone

Cell

E-mail

Security Coordinator

Alternate Security Coordinator

Review Team

Name

Title

Location Assignment

Telephone

E-mail

Lead

SSI

Secondary

SSI

TSS

TSA - HQ

OMB 1652-0050

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Sheet 3: 6-Month CFSR Follow-up Form

		DEPARTMENT OF HOMELAND SECURITY
		Transportation Security Administration
		Pipeline Critical Facility Security Review (CFSR)						CFSR FUF FY2021 V.2 (December 2020)
		6-Month Recommendations Follow-up Form
		Operator Name	<<< Corporate / Operator Name Here >>>			Report Date	10/1/2020	Response Codes
		City / State	0		0			1 - Recommendation has been completed/implemented
PSAT / TSI Name		Title		TSA Field Office	Telephone - Office	Telephone - Cell (Optional)	E-mail	2 - Recommendation will be completed/implemented
0		Lead		SSI	0		0	3 - Recommendation being evaluated
		Secondary		SSI				4 - Recommendation will not be completed/implemented
		TSS		TSA - HQ				5 - Recommendation no longer applicable
Operator Representative Reporting	Facility Name	CFSR Date	Response or Resolution Date	Recommendation #	CFSR Question #	Recommendation or Question Narrative	Stakeholder Response Narrative	Stakeholder Response Code

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Sheet 4: 12-Month CFSR Follow-up Form

		DEPARTMENT OF HOMELAND SECURITY
		Transportation Security Administration
		Pipeline Critical Facility Security Review (CFSR)						CFSR FUF FY2021 V.2 (December 2020)
		12-Month Recommendations Follow-up Form
		Operator Name	<<< Corporate / Operator Name Here >>>			Report Date	10/1/2020	Response Codes
		City / State	0		0			1 - Recommendation has been completed/implemented
PSAT / TSI Name		Title		TSA Field Office	Telephone - Office	Telephone - Cell (Optional)	E-mail	2 - Recommendation will be completed/implemented
0		Lead		SSI	0		0	3 - Recommendation being evaluated
		Secondary		SSI				4 - Recommendation will not be completed/implemented
		TSS		TSA - HQ				5 - Recommendation no longer applicable
Operator Representative Reporting	Facility Name	CFSR Date	Response or Resolution Date	Recommendation #	CFSR Question #	Recommendation or Question Narrative	Stakeholder Response Narrative	Stakeholder Response Code

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Sheet 5: 18-Month CFSR Follow-up Form

		DEPARTMENT OF HOMELAND SECURITY
		Transportation Security Administration
		Pipeline Critical Facility Security Review (CFSR)						CFSR FUF FY2021 V.2 (December 2020)
		18-Month Recommendations Follow-up Form
		Operator Name	<<< Corporate / Operator Name Here >>>			Report Date	10/1/2020	Response Codes
		City / State	0		0			1 - Recommendation has been completed/implemented
PSAT / TSI Name		Title		TSA Field Office	Telephone - Office	Telephone - Cell (Optional)	E-mail	2 - Recommendation will be completed/implemented
0		Lead		SSI	0		0	3 - Recommendation being evaluated
		Secondary		SSI				4 - Recommendation will not be completed/implemented
		TSS		TSA - HQ				5 - Recommendation no longer applicable
Operator Representative Reporting	Facility Name	CFSR Date	Response or Resolution Date	Recommendation #	CFSR Question #	Recommendation or Question Narrative	Stakeholder Response Narrative	Stakeholder Response Code

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Sheet 6: Summary

		DEPARTMENT OF HOMELAND SECURITY
		Transportation Security Administration
		Pipeline Critical Facility Security Review (CFSR)						CFSR FUF FY2021 V.2 (December 2020)
		Summary Follow-up Form
		Operator Name	<<< Corporate / Operator Name Here >>>			Report Date	10/1/2020	Response Codes
		City / State	0		0			1 - Recommendation has been completed/implemented
PSAT / TSI Name		Title		TSA Field Office	Telephone - Office	Telephone - Cell (Optional)	E-mail	2 - Recommendation will be completed/implemented
0		Lead		SSI	0		0	3 - Recommendation being evaluated
		Secondary		SSI				4 - Recommendation will not be completed/implemented
		TSS		TSA - HQ				5 - Recommendation no longer applicable
	Original Number of Recommendations	0
	Follow-up	Number of Recommedations with Positive Implementation		Cummulative Percentage of Positive Implementation
	6-Month CFSR Follow-up	0		#DIV/0!
	12-Month CFSR Follow-up	0		#DIV/0!
	18-Month CFSR Follow-up	0		#DIV/0!

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Sheet 7: PRA Burden

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 OMB number for this for is 1652-0050, which expires 11/31/2021. Transportation Security Administration estimates that the average burden for the CFSR Recommendation Follow-up collection is 6 hours.  You may submit any comments concerning the accuracy of this burden estimate or any suggestions for reducing the burden to:  TSA-11, Attention: PRA 1652-0050, 6595 Springfield Center Drive, Springfield, VA 20598-6011.