Form TSA Form 2808-R TSA Form 2808-R Retired Badge and/or Retired Credential Application

OMB Control Number: 1652-0071
Expiration Date: 11/30/2025

DEPARTMENT OF HOMELAND SECURITY

Transportation Security Administration
RETIRED BADGE AND/OR RETIRED CREDENTIAL APPLICATION

INSTRUCTIONS: This form shall be completed in accordance with TSA MD 2800.11, Badge and Credential Program and
Handbook. To apply for a Retired Badge and/or Retired Credential the applicant must complete Sections I-IV. Section V requires
review and approval by the applicant's supervisor (J-Band and above). All parts of Section VI must be completed and subsequently
approved by the BMO Director/FSD/SAC equivalent (K-Band and above). Completed forms shall be stored in accordance with TSA
File Code 2800.17. The completed application must be emailed to the Physical Security Branch at the email address:
CredentialBadgeCustS@tsa.dhs.gov.
SECTION I. Application Type and Date
Application Date
PART A. Applicant Information
Last Name

Retired Badge

Select application type(s)
First Name

Date of Birth

Maiden/ Middle Name

TSA Entry on Duty date

Type of Retirement

Retired Credential
Social Security Number

Retirement Date

Office/ Divisions

Official Title (At time of retirement)

Government email address (if applicable)

Personal Phone Number

Personal Email Address

SECTION II. Retired Badge
Category
Replacement Reason
SECTION III. Retired Credential
Category
Replacement Reason
Official Title (please refer to SF-50, Notice of Personnel Action)
SECTION IV. Retired Badge or Credential Waiver/Acknowledgement and Eligibility
The TSA retired badge or credential does not confer powers [law enforcement or non-law enforcement] or authorize engagement in
any law enforcement activities and investigations. I waive the right to make a claim of any description to include claims, actions,
suits, procedures, costs, expenses, damages, and liabilities against TSA resulting from the authority to carry retired badge and/or
credentials.
I acknowledge that I have read and understand the information provided above.
Date

Signature

SECTION V. Supervisor Approval (J-Band and Above Use Only)
Last, First, MI
Position or Title
TSA Component
Office Phone

Government Email Address
Cell Phone

Signature

Date

SECTION VI. BMO Director/ FSD/ SAC Equivalent Approval (K-Band and Above Use Only)
Part A. Good Standing Determination
Select One – Yes or No
1. There was a determination made, or action initiated to remove or proposal to remove, the employee from federal
employment;
2. There was an investigation or unadjudicated charge of misconduct against the employee that could have led to the
employee’s removal; or
3. The employee’s security clearance was suspended or revoked, or a proposal to suspend or revoke the clearance
was initiated or issued.
Previous editions of this form are obsolete.
TSA Form 2808-R (12/22) rev. [File: 2800.17]

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OMB Control Number: 1652-0071
Expiration Date: 11/30/2025
Part B. Service Eligibility
1. The employee completed five (5) years of service with TSA.
2. The employee was in good standing at the time of retirement. (Requires “No” response to questions 1,2, and 3
on Part A.); and
3. The employee retired consistent with the retirement definition in TSA MD 2800.11, Badge and Credential Program
I have reviewed the criteria with the appropriate offices and I find the employee:
Meets all the criteria and is eligible for a retired badge and/or credential. (Requires “Yes” to questions 1, 2, and 3 in Part B.).
Does not meet all the above criteria and is not eligible for a retired badge and/or credential.
By signing below in Part C. you acknowledge that Part A. Good Standing Determination and Part B. Service Eligibility are true
and correct.
Part C. BMO Director/FSD/SAC Equivalent (K-Band and Above) Approval
Last, First, MI
Position or Title
Date of Approval
TSA Component

Government Email Address

Office Phone

Cell Phone

Signature

SECTION VII. PHYSICAL SECURITY SECTION USE ONLY
Badge
Badge
Badge

Tactical Badge

Badge Type and Number

Tactical Badge number (if applicable)

Old Badge Number
If no, explain

Old Badge Returned

Lost/Stolen/Damaged Badge reported in accordance to TSA MD 2800.11, Handbook
Approved
Credential
Credential

Date Reported

If Disapproved, explain
Credential Type

Credential Number

Old Credential Number

Old Credential Returned

If no, explain

Lost/Stolen/Damaged Credential reported in accordance with TSA MD 2800.11, Handbook
Date Reported

Approved

If disapproved, explain
Signatures and Approvals
Approving Official’s Name

Title

Date
Comments

Signature

PRIVACY ACT STATEMENT: Authority: 49 U.S.C. § 114(f). Principal Purpose(s): This information will be used to show official receipt
of government property and to track case status and generate reports regarding badging and credentialing. Routine Use(s): This
information may be shared with another federal agency in response to its request in connection with the hiring or retention of an
employee or the issuance of a security clearance, or for the routine uses identified in TSA system of records, DHS/TSA 002, Security
Threat Assessment System (T-STAS). Disclosure: Voluntary; failure to furnish the requested information may result in delays in
issuing you a badge or credential or an inability to issue you a badge or credential. Failure to furnish your SSN may result in delays or
inability to issue you a badge or credential.
PAPERWORK REDUCTION ACT STATEMENT: This is a mandatory collection to participate in the Retired Badge/Credential Program.
The total average burden per response associated with this collection is estimated to be approximately 5 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 assigned to this collection is OMB 1652-0071, which will expire on 11/30/2025. Send comments
regarding this burden estimate or collection to: TSA-11, Attention: PRA 1652-0071, 6595 Springfield Center Drive, Springfield, VA
20598-6045.

Previous editions of this form are obsolete.
TSA Form 2808-R (12/22) rev. [File: 2800.17]

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