USM3A Application for Special Deputation

Scanned copies of this form will not be accepted. Only electronically fillable forms
will be accepted unless otherwise instructed by SDP.

OMB Number 1105-0094 (Exp. 09/30/2025)

Application for Special Deputation/
Sponsoring Federal Agency Information

U.S. Department of Justice
United States Marshals Service
APPLICANT INFORMATION - To be completed and signed by the applicant.
* 1. Applicant - Last Name:

* First Name:

* 2. Date of Birth (MM/DD/YYYY):

* 3. SSN (Last 4 Digits):

* 5. Employer Address - Street:
* 9. Work Telephone:

Middle Initial:

* 4. Employer:
* 6. City:

Ext.:

Suffix:

* 7. State:

* 8. ZIP Code:

* 10. Work E-mail Address:

* 11. Job Title (with employer indicated in Question #4; cannot be Task Force Officer):

12. Job Series (If Federal Employee):

Yes

No

* 13. I am a citizen of the United States of America.

Yes

No

* 14. I am employed as a full-time law enforcement officer by a federal, state, local or tribal law enforcement agency, or
an agency approved by the U.S. DOJ.

Yes

No

* 15. I have successfully completed a basic law enforcement training program or military equivalent (EXCEPTION:
Executive Office of United States Attorneys). If 'No', state what course you have completed that is (FLETC)
comparable and provide documentation and/or certificate of completion:
Academy:
Location - City:

Yes

No

Course Name:
State:

* 16. I had a 5-year break in law enforcement, however, I have completed a law enforcement refresher course within the
past year of signing this application (attach certificate):
Agency:

Course Name:

Location - City:

Yes

No

Completion Date (MM/YYYY):

State:

Completion Date (MM/YYYY):

* 17. I have at least one year of basic law enforcement experience to include general arrest authority. (If no general
arrest authority, provide letter explaining what your authority was or is.)
Agency:

Location - City:

State:

Present
to MM/YYYY:
Dates - MM/YYYY:
If you are currently working as a LEO with basic arrest authority, please list your start date (MM/YYYY) and check ‘Present’.

Yes

No

* 18. I have not been convicted of a crime of domestic violence as defined in Title 18 U.S.C. Section 922 (g)(9)
Lautenberg Amendment.

Yes

No

* 19. I have qualified with my primary authorized firearm. Give full description (firearm manufacturer, model, caliber):
Manufacturer (Make):

Model:

Caliber:

(Qualification date must be within one year of application date.)

Qualification Date (MM/DD/YYYY):

Yes

No

* 20. I have read and I agree to comply with the deadly force and use of less than lethal device policies of either my
agency or the U.S. DOJ.

Yes

No

* 21. I have included a copy of my employer's authorization letter and I acknowledge that the information provided in that
document is accurate.

Yes

No

N/A

* 22. To be completed by Protection Details only:
I have successfully completed the following basic protective services training program (or other (FLETC)
comparable course) and have included a copy of my completion certificate/documentation.

Course Name:
Location - City:

State:

Completion Date (MM/YYYY):

* 23. APPLICANT CERTIFICATION: I certify that the above statements are true and accurate. (False or fraudulent information knowingly

provided on this form is criminally punishable pursuant to federal law, including Title 18 U.S.C. Section 1001.) NOTE: Date of signature
must be on or after your firearms qualification date (#19).
Date:

Signature of Applicant:
Must be electronically signed or digitally signed with certificate

* = Required Field

Page 1 of 3

Form USM-3A
Rev. 12/25

SPONSORING FEDERAL AGENCY INFORMATION - To be completed by the sponsoring agency point of contact and signed by the sponsor.
* 24. Sponsoring Agency Name:

* 25. District of Swearing-In Location:

* 26. Name of Sponsor:

* 27. Agency Phone Number:

* 28. Sponsoring Agency Address - Street:
* 32. Name of District Contact:

* 29. City:
* 33. Telephone:

* 35. Name of Sponsored Applicant (from Question #1):
* 37. Has the applicant ever been deputized before?

Ext.:

* 30. State:

Ext.:

* 31. ZIP Code:

* 34. Work E-mail Address:

* 36. Applicant Employer (from Question #4):
No

Yes - Most recent deputation expiration date (MM/DD/YYYY):

* 38. Task Force Name:
* 39. Provide a justification for the special deputation, to include a description of the mission and an explanation of why the applicant requires
U.S.C. Title 18 authority to support that mission (500 character limit).

Provide full details and supporting documentation for all "NO" answers:
Yes

No

* 40. I have reviewed the Application for Special Deputation / Sponsoring Federal Agency Information (Form USM-3A) submitted
by the applicant for Special Deputation and verify that the statements submitted by the applicant are true and correct.

Yes

No

* 41. I have ensured the applicant has read and understood the current deadly force and use of less than lethal device policies
from the employing agency or the U.S. DOJ.

Yes

No

* 42. I have included a copy of the applicant's employer's authorization letter. The employer is aware of all misconduct reporting
requirements for this applicant. Sponsoring agencies shall promptly inform the USMS if the following occur: The individual
is subject to criminal investigation or criminal charges through arrest, information, or indictment; the individual's serious
misconduct (unlawful violence, improper profiling, bias, or deprivation of civil rights) becomes the basis of a settlement,
judgment, sustained complaint, or finding of unlawful violence, improper profiling, bias, or deprivation of civil rights; or the
individual's conduct is the subject of a misconduct investigation likely to lead to discipline resulting in the individual's
suspension or removal from employment. Outcomes of a misconduct investigation provided to the sponsoring agency will
be promptly provided to the USMS.

Yes

No

N/A

* 43. Non-USMS SPONSORING AGENCIES - I understand that SpDUSMs, acting under the authority of their
federal deputation, may only conduct electronic surveillance in non-USMS investigations in strict adherence to
federal and state law, and United States Department of Justice policy, and only with the explicit approval and
under the supervision, control and scope of authority of the non-USMS sponsoring agency, whose
responsibility it is to ensure that all ELSUR conducted by its sponsored SpDUSM personnel is conducted
lawfully and consistent with United States Department of Justice policy. SpDUSM may not conduct electronic
surveillance pursuant to their SpDUSM authority on non-sponsoring agency cases. Violation of these
proscriptions will result in this special deputation being revoked.

Yes

No

N/A

* 44. USMS ONLY - I understand that SpDUSMs are prohibited from conducting electronic or financial surveillance
in USMS and USMS-adopted investigations without the written approval of the USMS Investigative Operations
Division, Technical Operations Group.

Yes

No

N/A

* 45. USMS ONLY - Will the applicant be assigned to a USMS Task Force on a full-time basis? (Note: TFOs who are
active on a USMS Task Force for an aggregate of more than 180 days per year are considered full-time).

Yes

No

N/A

* 46. USMS ONLY - I have attached a copy of the favorable background investigation adjudication memorandum or
conditional waiver. (NOTE: Applications for full-time TFOs will not be processed unless a background
investigation adjudication memorandum or conditional waiver is included with the application materials).

Yes

No

N/A

* 47. USMS ONLY - The applicant has completed all training requirements outlined within the Task Force Officer
Training Attestation Form (NOTE: Applications for full-time TFOs will not be processed unless this training has
been completed).

* 48. SPONSOR CERTIFICATION: I certify that the above statements are true and accurate and that I have reviewed the applicant's statements. (False
or fraudulent information knowingly provided on this form is criminally punishable pursuant to federal law, including Title 18 U.S.C. Section 1001.)
Sign and date only after applicant has signed and dated page 1.
Date:

Signature of Sponsor:
Must be electronically signed or digitally signed with certificate

* = Required Field

Page 2 of 3

Form USM-3A
Rev. 12/25

** PLEASE ATTACH THE FOLLOWING DOCUMENT(S) ALONG WITH YOUR APPLICATION SUBMISSION: **
- Documentation and/or certificate of completion if applicant did not complete basic law enforcement training program or military equivalent (see
Question #15).
- Certificate of law enforcement refresher course, if applicable (see Question #16).
- Letter explaining authority, if no general arrest authority (see Question #17).
- Copy of applicant's employer's authorization letter on official letterhead stating that they concur with the applicant's participation and that the applicant
is not currently subject of any internal investigations pending within the organization (see Question #21).
- USMS ONLY: Copy of the favorable background investigation adjudication memorandum (see Question #45).
- Full-Time Basis: SpDUSMs or TFOs are assigned to a USMS District Fugitive Task Force or a Regional Fugitive Task Force (RFTF) with an executed
Memorandum of Understanding (MOU), who require full-time unescorted access to USMS space or systems and have a successfully completed BI by
the TOD-PSB. As a result, they are eligible to receive a PIV card and issued unique credentials and/or badges.
- Part-Time Basis: SpDUSMs or TFOs assigned to a USMS District Fugitive Task Force or RFTF with an executed MOU, that are intermittent or
temporary in nature, not to exceed an aggregate of 180 days per year that do not require a BI for fitness by the TOD-PSB. As a result, they are
required to be always escorted while in USMS space and are not authorized to have access to USMS systems.

Submit to svc-iaews-prod@usdoj.gov
USMS SPECIAL DEPUTATION PROGRAM USE ONLY
Signature of Assistant Chief Inspector, Special Deputation Program or Designee
Approved
Date:

Disapproved
Signature:
Must be electronically signed or digitally signed with certificate

INSTRUCTIONS TO COMPLETE THIS FORM
1. Applications are only accepted typewritten and electronically via e-mail (to svc-iaews-prod@usdoj.gov) from the Sponsoring Agency.
2. Applicants must be provided with a copy of the U.S. Marshals Service deadly force policy from the sponsoring agency or from the
Department of Justice.
3. Applicants must be sponsored by a Federal Law Enforcement Agency.
4. Renewal requests must be received 60 days prior to the expiration of the current Special Deputation expiration date.
5. Complete all fields. Typewritten only. If no response is necessary or applicable, indicate this on the form (for example, enter "None" or "N/A").
6. Any changes that you make to this form after you sign it must be initialed and dated by you. Under certain limited circumstances, USMS may
modify the form consistent with your intent.
7. You must use U.S. Postal Service 2-letter state abbreviations when you fill out this form. Do not abbreviate the names of cities or foreign
countries.
8. All telephone numbers must include area codes.
9. Attach all required documentation, as listed at the top of this page, to your email submission.
10. All signatures must be either electronically signed or digitally signed with certificate. For examples of signatures, please reference the
Frequently Asked Questions document or contact your sponsoring agency.
Privacy Act Statement
The authority for collection of the information on this form is 28 CFR subpart T, 0.112, 28 U.S.C. 561 through 569. The USMS is authorized to deputize
selected persons to perform the functions of a Deputy U.S. Marshal whenever the law enforcement needs of the USMS so require, to provide courtroom
security for the Federal judiciary, and as designated by the Associate Attorney General pursuant to 28 CFR 0.19(a)(3). This form serves as a record of
the special deputations granted by the USMS to assist in tracking, controlling and monitoring the Special Deputation Program. Your Social Security
number is requested as an additional identifier pursuant to Executive Order 9397. Disclosure of the information on this form is voluntary, however, failure
to provide the information may result in your disqualification for special deputation.
This form may be routinely disclosed: To a federal, state or local law enforcement agency regarding that agency's USMS deputized employees; Where a
record, either alone or in conjunction with other information, indicates a violation or potential violation of law - criminal, civil, or regulatory in nature - the
relevant records may be referred to the appropriate federal, state, local, territorial, tribal, or foreign law enforcement authority or other appropriate entity
charged with the responsibility for investigating or prosecuting such violation or charged with enforcing or implementing such law; and as otherwise
provided in USMS Privacy Act system of records notice Justice/USM-004, Special Deputation Files, 72 FR 33515 (June 18, 2007).
Public reporting burden for this collection of information is estimated to average 15 minutes per response, including the time for reviewing instructions,
searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send
comments regarding this burden estimate or any other aspects of this collection of information, including suggestions for reducing this burden, to U.S.
Marshals Service, Tactical Operations Division, Attn: Special Deputation Program, Washington, DC 20530-0001.
An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB
control number.

* = Required Field

Page 3 of 3

Form USM-3A
Rev. 12/25