[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-1-en-105":3,"doc-seo-283673-105":53,"doc-detail-283673-en":119},{"code":4,"msg":5,"data":6},0,"success",[7,14,19,24,29,34,39,44,49],{"id":8,"doc_module":9,"doc_module_name":10,"category_name":11,"show_sort_weight":12,"slug":13},11,1,"Template","Presentations",90,"presentations",{"id":15,"doc_module":9,"doc_module_name":10,"category_name":16,"show_sort_weight":17,"slug":18},12,"Resumes",80,"resumes",{"id":20,"doc_module":9,"doc_module_name":10,"category_name":21,"show_sort_weight":22,"slug":23},14,"Invoices",70,"invoices",{"id":25,"doc_module":9,"doc_module_name":10,"category_name":26,"show_sort_weight":27,"slug":28},15,"Posters",60,"posters",{"id":30,"doc_module":9,"doc_module_name":10,"category_name":31,"show_sort_weight":32,"slug":33},16,"Social Media",50,"social-media",{"id":35,"doc_module":9,"doc_module_name":10,"category_name":36,"show_sort_weight":37,"slug":38},17,"Forms",40,"forms",{"id":40,"doc_module":9,"doc_module_name":10,"category_name":41,"show_sort_weight":42,"slug":43},18,"Letters",30,"letters",{"id":45,"doc_module":9,"doc_module_name":10,"category_name":46,"show_sort_weight":47,"slug":48},21,"Paper Templates",5,"papers-templates",{"id":50,"doc_module":9,"doc_module_name":10,"category_name":51,"show_sort_weight":4,"slug":52},158,"General","general-158",{"code":4,"msg":54,"data":55},"ok",{"site_id":56,"language":57,"slug":58,"title":59,"keywords":60,"description":61,"schema_data":62,"social_meta":112,"head_meta":114,"extra_data":116,"updated_unix":118},105,"en","predict-authorization-letter-for-data-provider","PREDICT Authorization Letter for Data Provider","","DHS PREDICT Authorization Letter for Data Provider is a cover letter and form letter template used by a sponsoring organization to authorize specific staff to act as Data Providers for the PREDICT system. The document outlines required cover sheet details, explains how to complete and print the authorization on institutional letterhead, and specifies submission by signing and faxing to the PREDICT Coordinating Center (RTI International). It also includes directions to fill names, titles, dates, and signature authority, plus a formal application statement confirming staff affiliation and authority to provide data.",{"@graph":63,"@context":111},[64,80,102],{"@type":65,"itemListElement":66},"BreadcrumbList",[67,71,74,77],{"item":68,"name":69,"@type":70,"position":9},"https://docshare.wps.com","Home","ListItem",{"item":72,"name":10,"@type":70,"position":73},"https://docshare.wps.com/template/",2,{"item":75,"name":41,"@type":70,"position":76},"https://docshare.wps.com/template/letters/",3,{"item":78,"name":59,"@type":70,"position":79},"https://docshare.wps.com/template/predict-authorization-letter-for-data-provider/283673/",4,{"url":78,"name":59,"@type":81,"image":82,"author":87,"headline":59,"publisher":90,"fileFormat":93,"inLanguage":57,"description":61,"dateModified":94,"datePublished":95,"encodingFormat":93,"isAccessibleForFree":96,"interactionStatistic":97},"DigitalDocument",{"url":83,"@type":84,"width":85,"height":86},"https://docshare.wps.com/thumbnails/predict-authorization-letter-for-data-provider/283673.png","ImageObject",442,249,{"name":88,"@type":89},"\tJames","Person",{"url":68,"name":91,"@type":92},"DocShare","Organization","application/pdf","2026-10-20","2026-09-17",true,{"@type":98,"interactionType":99,"userInteractionCount":101},"InteractionCounter",{"@type":100},"ViewAction",6,{"@type":103,"mainEntity":104},"FAQPage",[105],{"name":106,"@type":107,"acceptedAnswer":108},"How should the completed authorization letter be submitted?","Question",{"text":109,"@type":110},"The completed and signed letter must be received and approved by the PREDICT Coordinating Center; submission is specified as signing and faxing to the PREDICT Coordinating Center at the listed RTI International contact.","Answer","https://schema.org",{"og:url":78,"og:type":113,"og:title":59,"og:site_name":91,"og:description":61},"article",{"robots":115,"canonical":78},"index,follow",{"doc_id":117,"site_id":56},283673,1790446858,{"code":4,"msg":5,"data":120},{"doc_id":117,"user_id":121,"nickname":88,"user_avatar":122,"doc_module":9,"category_id":40,"category_name":41,"doc_title":59,"doc_description":61,"doc_content":123,"file_id":124,"file_url":125,"file_type":126,"file_size":127,"view_count":101,"is_deleted":4,"is_public":9,"is_downloadable":9,"audit_status":9,"page_count":79,"language":128,"language_code":57,"site_id":56,"html_lang":57,"table_of_contents":129,"faqs":130,"seo_title":131,"seo_description":61,"update_tm":132,"read_time":73},2336474466412,"https://ap-avatar.wpscdn.com/davatar_155a257f0dc6eb9ab79c44ca47cae57d","OMB No. 1640-New Expires: TBD  \nDHS PREDICT Authorization Letter for Data Provider Form  \nCover Sheet  \n1. Department Name: Department of Homeland Security  \n2. Component/Agency Name: Science and Technology Directorate  \n3. OMB Control Number: 1640-New  \n4. Expiration Date: TBD (Three years from approval date)  \n5. Agency Form Number: TBD  \n6. Name of Form: Authorization Letter for Data Provider  \n7. Purpose of Form: Required Form Letter to be filled out by sponsoring organization to allow user to serve as a Data Provider for the PREDICT system  \n8. How to submit: Sign and fax to the PREDICT Coordinating Center, RTI International, Attn: Renee Karlsen, 866.835.0255 (toll free) .  \nCOVER LETTER  \nAUTHORIZATION LETTER FOR DATA PROVIDER  \nREAD THESE INSTRUCTIONS CAREFULLY BEFORE PROCEEDING  \nThank you for your interest in joining the PREDICT community as a Data Provider. In order for your application to be considered, you must have a supervisor or other official, who has the authority to sign on behalf of your organization, execute the attached Authorization Letter. Please be sure to provide these instructions along with the Authorization Letter template when requesting a signature. The completed and signed Authorization Letter must be received and approved by the PREDICT Coordinating Center (PCC) before your application for an account as a Data Provider can be considered.  \nDirections:  \n1. Print this letter on your institution’s letterhead. You may do this in two ways:  \na. Cut and paste the text of the letter into your word processing program so you can fill in the information requested using your institution’s letterhead. Once you have inserted the information, you can save and print the letter. Note: you will need to adjust the formatting for the word processing program you are using.  \nb. Fill in the form within the PDF. The top margin is about 1.5 inches to accommodate letterhead. Print the letter on your institution’s letterhead.  \n2. Fill in appropriate names, dates, and other information where indicated with the requested information. Do not omit any of the requested information or your application will be rejected  \na. Use one copy of the letter to cover multiple members of your team, if needed.  \nb. Optional: Insert the prefix appropriate to the researcher(s) (Dr., Ms, Miss, Mrs., Mr.)  \nc. Spell out the name of your company, organization, and/or title. Do not abbreviate.  \n3. Print the Authorization Letter.  \n4. Sign and fax the Authorization Letter to the PREDICT Coordinating Center, RTI International, Attn: Renee Karlsen, 866.835.0255 (toll free) .  \nQuestions regarding your application may be directed to the PREDICT Coordinating Center, [at](at predict-contact@rti.org)[ ](at predict-contact@rti.org)[predict-contact@rti.org](at predict-contact@rti.org).  \nPREDICT_AuthorizationLtr_DP_v1 .0 11/26/2007  \nToday’s Date  \nRTI International, Inc.  \nAttn: Renee Karlsen PREDICT Coordinating Center PO Box 12194  \nResearch Triangle Park, NC 27709-2194  \nSUBJECT: Application for access to the PREDICT portal as a Data Provider.  \nDear Ms. Karlsen:  \nI am writing on behalf of the staff named below to apply for access to the PREDICT portal website as a Data Provider, with the portal privileges accorded to Data Providers. I understand that a letter of authorization from a Sponsoring Institution is one of the required elements of a successful application, and this letter is intended to serve that purpose.  \nBy this letter, I am confirming on behalf of myself and my organization,  \n  that: (Fill in all information and sign below):  \n1. This letter is being sent on behalf of the following staff (Applicant(s)):  \n\n| Full Name | \u003Cbr>\u003Cbr>Years with Sponsoring Organization | Title | \u003Cbr>\u003Cbr>Signature Authority to Bind Org (Y/N) |\n| --- | --- | --- | --- |\n|  |  |  |  |\n|  |  |  |  |\n|  |  |  |  |\n|  |  |  |  |\n|  |  |  |  |\n\nPREDICT_AuthorizationLtr_DP_v1 .0 11/26/2007  \n2. All named Applicant(s) are currently affiliated with this organiz","cbCair2WNDvuZXaa","https://ap.wps.com/l/cbCair2WNDvuZXaa","pdf",159647,"English","# Cover Sheet\n## Instructions for Completing and Submitting the Authorization Letter\n# Authorization Letter (Data Provider Application)","[{\"question\":\"How should the completed authorization letter be submitted?\",\"answer\":\"The completed and signed letter must be received and approved by the PREDICT Coordinating Center; submission is specified as signing and faxing to the PREDICT Coordinating Center at the listed RTI International contact.\"}]","PREDICT Authorization Letter for Data Provider | PDF",1789616591]