ML11321A240

NRC Form 754 - Armed Security Personnel Firearms Background Check

ML11321A240
Person / Time
Issue date:	01/09/2023
From:	NRC/OCIO/GEMSD/DPRB
To:
References
Download: ML11321A240 (3)

Text

NRC FORM 754 (11-18-2024)

U.S. NUCLEAR REGULATORY COMMISSION ARMED SECURITY PERSONNEL FIREARMS BACKGROUND CHECK APPROVED BY OMB: NO. 3150-0204 EXPIRES: 03/31/2026 Estimated burden per response to comply with this mandatory information collection request: 2.2 hours2.314815e-5 days <br />5.555556e-4 hours <br />3.306878e-6 weeks <br />7.61e-7 months <br />. NRC uses the information to verify that personnel protecting NRC-regulated entities are not prohibited from receiving, possessing, transporting, importing, or using covered weapons as part of the performance of their official duties. Send comments regarding burden estimate to the FOIA, Library, and Information Collections Branch (T-6 A10M), U.S. Nuclear Regulatory Commission, Washington, DC 20555-0001, or by email to Infocollects.Resource@nrc.gov,and the OMB reviewer at: OMB Office of Information and Regulatory Affairs, (3150-0204), Attn: Desk Officer for the Nuclear Regulatory Commission, 725 17th Street NW, Washington, DC 20503. The NRC may not conduct or sponsor, and a person is not required to respond to, a collection of information unless the document requesting or requiring the collection displays a currently valid OMB control number.

NICS Transaction Number (NTN)

Warning: Security personnel protecting NRC designated facilities, radioactive material, or other property are not authorized to receive, possess, transport, import, or use firearms pursuant to § 161A of The Atomic Energy Act of 1954, as amended, 42 U.S.C. § 2201a, if prohibited under Federal or State law. The information you provide will be used to verify that you are not prohibited under Federal or State law from receiving, possessing, transporting, importing, or using any firearms.

Prepare in original only. Must be completed personally by individual. All entries must be in ink. Please type or print all information. Read the Important Notices, Instructions, and Definitions on this form.

1. Individual's Full Name (Last, First, Middle) (If no middle name state "NMN")

2. Other Previously Used Names (e.g., Maiden) (Last, First, or Middle)

3. Current Residence Address (Cannot be a post office box) (U.S. Postal abbreviations are acceptable) (See Instruction 3)

Number and Street Address City County State Zip Code

4. Current Duty Station Location(s). (Use U.S. Postal abbreviations for the State or Territory) (See Instruction 4)

5. Place of Birth U.S. City/State - or -

Foreign Country

6. Height Ft.

In.

7. Weight lb.

8. Gender Male Female

10. Social Security Number (Enter 9 numeric digits)

11. Unique Personal Identification Number (UPIN), if applicable (See Instruction 5)

12. Race (Ethnicity) (Check one or more boxes) (See Instruction 6)

American Indian or Alaska Native Black or African American Native Hawaiian or Other Pacific Islander Hispanic or Latino Asian White

13. What is your country of citizenship? (List/check more than one, if applicable)

United States of America Other (Specify):

14. If you are not a citizen of the United States, what is your U.S. issued alien number or admission number?

15. If you are a nonimmigrant alien, what exception do you fall under as described in Important Notice 3, Exception 2? (Specify the documentation showing an exemption to the nonimmigrant alien prohibition)

I certify that the answers above are true and correct. I have read and understand the Important Notices, Instructions, and Definitions for this form. I understand that making any false oral or written statement is a crime punishable as a felony.

16. Security Personnel's Signature

17. Certification Date (MM/DD/YYYY)

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9. Birth Date (MM/DD/YYYY)

• Note: Social Security Numbers must not be visible on the outside of any package sent by mail.

SIGN

NRC FORM 754 (11-18-2024)

U.S. NUCLEAR REGULATORY COMMISSION ARMED SECURITY PERSONNEL FIREARMS BACKGROUND CHECK (Continued)

Important Notices

1. Purpose of the Form: The information and certification on this form are designed to support a verification that security personnel protecting U.S. Nuclear Regulatory Commission (NRC) designated facilities, radioactive material, or other property are not prohibited from receiving, possessing, transporting, or using firearms as part of the performance of their official duties under § 161A of the Atomic Energy Act of 1954, as amended (AEA), 42 U.S.C. § 2201a. Submission of this form is mandatory for security personnel of license holders who apply to the NRC for Section 161A. authority. Failure to submit this form will result in the individual being denied access to firearms as part of their official security duties at NRC-regulated entities.

Evaluation of the information contained in this form will permit the NRC to verify that individuals who are prohibited from possessing or receiving any firearms under Federal or State law do not possess or receive firearms (including enhanced weapons) as part of their current or proposed official duties as security personnel.

This determination is required of all security personnel protecting NRC designated facilities, radioactive material, or other property.

2. Background Checks: Section 161A requires that security personnel receiving, possessing, transporting, or using a covered weapon shall be subject to a background check by the Attorney General, based on fingerprints and including a background check under section 103(b) of the Brady Handgun Violence Prevention Act (Brady Act), Public Law 103-159, 18 U.S.C. § 922(t), to determine whether the person is prohibited from possessing or receiving firearms under Federal or State law. The Brady Act provides for the submission of information to the Federal Bureau of Investigation's (FBI's) National Instant Criminal Background Check Systems (NICS) to verify that an individual is not prohibited under Federal or State law from possessing or receiving firearms.

3. Prohibited Persons: Generally, 18 U.S.C. § 922 prohibits the shipment, transportation, receipt, or possession in or affecting interstate commerce of firearms by anyone who: (1) has been convicted of a misdemeanor crime of domestic violence; (2) has been convicted of a felony, or any other crime, punishable by imprisonment for a term exceeding one year (this does not include State misdemeanors punishable by imprisonment of two years or less); (3) is a fugitive from justice; (4) is an unlawful user of, or addicted to, marijuana or any depressant, stimulant, or narcotic drug, or any controlled substance; (5) has been adjudicated mentally defective or has been committed to a mental institution; (6) has been discharged from the Armed Forces under dishonorable conditions; (7) has renounced his or her U.S.

citizenship; (8) is an alien illegally in the United States or a nonimmigrant alien; or (9) is subject to certain restraining orders.

Furthermore, § 922 prohibits the shipment, transportation, or receipt of firearms to anyone who is under an indictment or information in any court for a felony, or any other crime, punishable by imprisonment for a term exceeding one year.

Exception 1: A person who has been convicted of a felony, or any other crime, for which the judge could have imprisoned the person for more than one year, or has been convicted of a misdemeanor crime of domestic violence, is not prohibited from receiving, possessing, transporting, importing, or using covered weapons if:

(1) under the law of the jurisdiction where the conviction occurred, the person has been pardoned, the conviction has been expunged or set aside, or the person has had certain civil rights (the right to vote, sit on a jury, and hold public office) restored AND (2) the person is not prohibited by the law of jurisdiction where the conviction occurred from receiving or possessing firearms.

Exception 2: A nonimmigrant alien is not prohibited from possessing or receiving a covered weapon as part of their official duties at NRC regulated facilities if the alien: (1) meets the exceptions of 18 U.S.C. § 922(y)(2)(B), (y)(2)(C), or (y)(2)(D); or (2) has received a waiver from the Attorney General of the United States (See 18 U.S.C. § 922(y)(3) for additional information on waivers.)

4. Restraining Order: Under 18 U.S.C. § 922, firearms may not be possessed or received by persons subject to a court order that:

(1) was issued after a hearing which the person received actual notice of and had an opportunity to participate in; (2) restrains such person from harassing, stalking, or threatening an intimate partner or child of such intimate partner or person, or engaging in other conduct that would place an intimate partner in reasonable fear of bodily injury to the partner or child; and (3)(i) includes a finding that such person represents a credible threat to the physical safety of such intimate partner or child; or (ii) by its terms explicitly prohibits the use, anticipated use, or threatened use of physical force against such intimate partner or child that would reasonably be expected to cause bodily injury.

5. NICS Responses: The FBI will provide a "proceed," "delayed," or "denied" NICS response and a NICS transaction number to the NRC that will be forwarded to you via your submitting license holders.

Instructions to Security Personnel

1. Individuals must personally complete this form and certify (sign) that the information on this form is true and correct.

2. If the individual is a member of the Armed Forces on active duty and is receiving, possessing, transporting, or using covered weapons in the State where his or her permanent duty station is located, but does not reside at his or her permanent duty station, the security personnel must list his or her permanent duty station address in the response to question 4 and his or her residence address in response to question 3.

3. Current Residence Address: If you are a U.S. citizen with two States of residence, you should list your current residence address.

4. Duty Station Location(s): Enter the U.S. Postal abbreviation for the State or Territory for the duty station location. Multiple States or Territories may be entered for multiple duty stations. For personnel escorting shipments of radioactive material or other property, enter the State or Territory affected by the shipment or enter "CONUS."

5. Unique Personal Identification Number (UPIN): If you have a UPIN issued to you by the FBI's NICS Voluntary Appeal File (based upon previous firearms transactions or based upon previous firearms security background checks), you should enter the UPIN under question 11. Entry of a UPIN is voluntary.

However, failure to provide your issued UPIN may result in a "delayed" or "denied" NICS response.

6. Race (Ethnicity): For any other race or ethnicity that does not fall within the indicated categories, please select the closest representation.

A person who has been convicted of a misdemeanor crime of domestic violence also is not prohibited unless: (1) the individual was represented by a lawyer or gave up the right to a lawyer; and (2) if the person was entitled to a jury, was tried by a jury, or gave up the right to a jury trial.

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NRC FORM 754 (11-18-2024)

U.S. NUCLEAR REGULATORY COMMISSION ARMED SECURITY PERSONNEL FIREARMS BACKGROUND CHECK (Continued)

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Definitions

1. Under indictment or information or conviction in any court:

An indictment, information, or conviction in Federal, State, or local court.

2. Misdemeanor Crime of Domestic Violence: A Federal, State, or local offense that is a misdemeanor under Federal or State law and has, as an element, the use or attempted use of physical force, or the threatened use of a deadly weapon, committed by a current or former spouse, parent, or guardian of the victim, by a person with whom the victim shares a child in common, by a person who is cohabiting with, or has cohabited with the victim as a spouse, parent, or guardian, or by a person similarly situated to a spouse, parent, or guardian of the victim. The term includes all misdemeanors that have as an element the use or attempted use of physical force or the threatened use of a deadly weapon (e.g.,

assault and battery), if the offense is committed by one of the defined parties.

3. Intimate Partner: An "intimate partner" of a person is: the spouse or former spouse of the person, the parent of a child of the person, or an individual who cohabits or has cohabited with the person.

4. State of Residence: The State in which an individual resides. An individual resides in a State if he or she is present in a State with the intention of making a home in that State. If an individual is a member of the Armed Forces on active duty, his or her State of residence also is the State in which his or her permanent duty station is located. An alien who is legally in the United States is a resident of a State only if the alien is residing in the State and has resided in the State continuously for at least 90 days immediately prior to the date of submission of this form.

5. Nonimmigrant Alien: An alien in the United States in a nonimmigrant classification. The definition includes, in large part, persons traveling temporarily in the United States for business or pleasure, persons studying in the United States who maintain a residence abroad, and certain foreign workers. The definition does NOT include permanent resident aliens.

6. Unique Personal Identification Number (UPIN): For individuals approved to have information maintained about them in FBI's NICS Voluntary Appeal File (VAF), NICS will provide them with a UPIN for their use in future firearms transactions or firearms background checks under § 161A of the AEA.

7. Covered Weapon: Covered weapon means any handgun, rifle, shotgun, short-barreled shotgun, short-barreled rifle, semi-automatic assault weapon, machine gun, ammunition for any such weapon, or large capacity ammunition feeding device as specified under section 161A. The terms "handgun, rifle, shotgun, short-barreled shotgun, short-barreled rifle, semi-automatic assault weapon, machine gun, ammunition, and large capacity ammunition feeding device" have the same meaning provided for these terms in 18 U.S.C. § 921(a).

PRIVACY ACT STATEMENT NRC FORM 754, ARMED SECURITY PERSONNEL FIREARMS BACKGROUND CHECK Pursuant to 5 U.S.C. 552(e)(3), enacted into law by Section 3 of the Privacy Act of 1974 (Public Law 93-579), the following statement is furnished to individuals who supply information to the Nuclear Regulatory Commission (NRC) on NRC Form 754.

This information is maintained in a system of records designated as NRC-39, described at 89 Federal Register 58792 (July 19, 2024), or the most recent Federal Register publication of the NRC's "Republication of Systems of Records Notices" that is located in the NRC's Agencywide Documents Access and Management System (ADAMS).

1. AUTHORITY: 1. 42 U.S.C. 2011 et seq.; 42 U.S.C. 2165, 2201(i), 2201a, and 2284; 42 U.S.C. 5801 et seq.; Social Security Number Fraud Prevention Act of 2017, 42 U.S.C. 405 note; Executive Order (E.O.) 9397, as amended by E.O. 13478; E.O. 10450, as amended; E.O. 10865, as amended; E.O. 13467; E.O. 13526; E.O. 13587; 10 CFR parts 10, 11, 14, 25, 50, 73, 95; OMB Circular No. A-130, Revised; 5 CFR parts 731, 732, and authorities cited therein.

2. PRINCIPAL PURPOSE(S): This form is used to perform a background check to verify that an individual is not prohibited from receiving, possessing, transporting, importing, or using covered weapons as part of the performance of their official duties.

3. ROUTINE USE(S): This information will be used to determine eligibility to receive, possess, transport, or import covered weapons. The information may also be disclosed to an appropriate Federal, State, local or foreign agency in the event the information indicates a violation or potential violation of law and in the course of an administrative or judicial proceeding. In addition, this information may be transferred to an appropriate Federal, State, local and foreign agency to the extent relevant and necessary for it to carry out its responsibilities under 161A of the Atomic Energy Act of 1954, as amended. Information may also be disclosed, in the course of discovery under a protective order issued by a court of competent jurisdiction, and in presenting evidence, to a Congressional office to respond to their inquiry made at your request, or to NRC-paid experts, consultants, and others under contract with the NRC, on a need-to-know basis.

4. WHETHER DISCLOSURE IS MANDATORY OR VOLUNTARY AND EFFECT ON INDIVIDUAL OF NOT PROVIDING INFORMATION: Disclosing this information is mandatory for security personnel of licensees and certificate holders who apply to the NRC for authority to possess covered weapons under section 161A of the Atomic Energy Act of 1954, as amended. Failure to submit a completed form will result in the individual being denied access to any covered weapons as part of their official security duties at NRC-regulated entities. The social security number is required to verify the individual's identity to facilitate the background check requirements.

5. SYSTEM MANAGER(S) AND ADDRESS: Director, Division of Facilities and Security, Office of Administration, U.S. Nuclear Regulatory Commission, Washington, DC 20555-0001.