ML20133P903

Request for OMB Review & Supporting Statements Re NRC 212A, Qualifications Investigation & Secretarial/Clerical. Estimated Respondent Burden Is 500 H

ML20133P903
Person / Time
Issue date:	10/28/1985
From:	Norry P NRC OFFICE OF ADMINISTRATION (ADM)
To:
References
OMB-3150-0034, OMB-3150-34, NUDOCS 8511010253
Download: ML20133P903 (5)

Text

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m m u m mrar m Cyrti m a T.f < N # Chv stancard t corn 8 3

. . . . , . . .s . m Request for DMB Review /

important Read instructions before completing form. Do not use the same SF 83 Send three copies of ttus form, the matenal to t>e sevitmed and for to recuest both an Executwe Order 12291 review and approval under paperwor k-thre, copies of the supporting statemer.t to the Paperwork Redaction Act Answer all questions in Part 1. If this request is for review under E O. Of f ece of information and Regu!atory Af f a'rs 12291, complete Part 11 and sign the regulatory certification if this Office of Management and Budget riquest is for approvat under the Paperwork Reduction Act and 5 CFR Attention Docket Library. Room 3201 1320, skip Part 11, complete Part ill and sign tne paper *or k certification Washington. DC 20503 PART l.-Complete This Part for All Requests.

1. Department /agenc y anc Burea.,/c'6ce ong.nating request j 2. A et.a r ot:e U. S. Nuclear Regulatory Comission 31.10_

3. Nams of person who can best anseer Qsestior>s redarcing this req est TEephonte rumbe-Mike Callahan < 301 ) 492-8263

4. Title of informat on codect+on or rutemaking NRC 212A, Qualitications Investigation, Secretarial / Clerical

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5. Legal autnonty f or enformat.on conect:en er rute (c:te unJea 5 fafes Code. FvDI c 1a*. or becutive Order) 42 usC 2201(o) . o, _ _

6. Affected pubbc(check alltha! app)) $ ] peep,alagencies cr ernployees 1 2 indiviewais or households 3 Farms 6 O Ncn proht ir st.tutions 2 O state oriocaigo.ernments 4 Businesses or otner for-profit 7 0 s< nan bus,nesses or crganizatrons PART li.-Complete This Part Only if the Request is for OMB Review Under Executive Order 12291

7. Regulation tderMe N Sber (RIN)

_ __ - . ~ _ _ _ _ , cr. Nor.e ass gned C

8. Type of subm'ssion (cnets one m ea:h category)

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Type ct resiew requested CCssification Stage of development 1 Standard 1 C Major 1 O r,eposed ordratt 2 O pend,ng 2 C Nonmajor 2 C Finalorintenmfinal.w'th pnorpreposal 3 C EmerEency 3 Final or intenm fina!. wrthout pnor proposal 4 C Statutcry or uoicalceadhne s

9. CFR sectron affected CFP

10. Does this regutation conta=n reportmg cr rerord6eep.ng recuiren>ents that rec; ura OMB opprovaltr'ver the Paperwon 4 c ut tien Act and 5 CFR 13.^0' [' m 0 t;o

11. If a major ruie. rs the e a rep.btc<y impad anaws a*tacnec) .{i % ; E re it t.o. ' M Ot.tB me m .:aw 3 0 w.. 4 0 rv Certification for Regulatory submissions M sovnitt" iin s requmt te Cr.m rer*. tr e utnvized ,q.ua " "'t-r t at+.;tr, er e" w . o S t+.at '. % . . n < ? e G ; ; t.1 ..e , ,.pp o.i g

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8511010253 851028 PDR ORG E R

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PART lli.-Cornplate This Patt Only if the Raquest is f of Approvalet a Collzction cf Int:rmation Under the Paperwerk Reduction Act and 5 CFR 1320.

13. Abstract-Desenbe needs. uses and attected pubi c in So words or iess

" Civil Service appointment, emp1oyment, hiring" Information received is used to determine qualifications and suitability of applicants for employment with the NRC.

14. Type of informaton coIIecton (check only one) 1:. formation collections not corrtained in rules 13 Regular submission 2 O Emergency submission (cerrefecationartxhed)

Information collections contained in rules 3 Existing regulaten (no change proposed) 6 Final or intenm final without pnor NPRM 7. Enter date of expected or actual Federat 4 O notice of proposed ruiemakms(NPRM) A O Regular submission Regtster pubhcaten at this stage of rulemaking 5 0 rmal, NPRM was previously pubbshed B Emergency subrnission (cerfihcation strached) (month. day. year).

15. Type of review requested (checa only one)

, 1 New coisection 4 Reinstatement of a previously approved collectioit for which approval 2 O Revision of a currentty approved coiiect,on * $ *d 3 @ Extension of the expiration date of a currently approved cocecton 5 O Existing collection m use without an oMB control number without any change in the substance or m the method of collection

16. Agency report form number (s)(inc?ude standard / optional form number (s)) 22. Purpose of mformatson collection (chech as many as apply)

NRC 212A * ^**"*"**"

2 O Program evaiuston

17. Annual reportmg or disclosure burden 3 General purpose statistics 1 Number of respondents . 2,000 4 O Regulatoryorcomphance 2 Number of responses per responcent l $ Program planning or management 3 Total ancual responses (hne 1 times hne 2) 2,000 ___ s p ,se ,ren 4 Hours per resNnse .25 7 Audit 5 Total hours thae 3 times hne 4) 500

18. Annualrecordweepngourcen 23. Frequency of recordkeeping or reportmg (check aIIthat apply) 1 Number of recorckeepers NA 1 Recordkeeping 2 Annual hours per recordkeeper. Resorting 3 Total recordneeping hours (hne 1 times hne 2) 2 O onoccasion 4 Recordkeepng retention period years 3 0 weekiy 19.Totzt Ennualburden 4 Monthay 1 Requested (kne 17 5 plus hne 18-3) . 500 s quar,er,y 2 in current oM8 inventory 500 s O semeannuany 3 Diff2rence(hne f less hoe 2; O 7 Annuairy Espianetton ofditforence a O Biennisa r 4 Program change 9 0 other(desenbe):

5 Adjustment .

20. CurrInt(most recent) oMB controf number or comment number 24. Respondents'oblegatton to cc,mply(check the strongest obhgation that af 3150-0034 1 [5 voiuntary

21. Requ:sted expiration care 2 O Required to obtain or retain a beneta 12/31/88 l 3 O Mandatorr

25. Are the respondents pnmanly ecucational agencies or institutior's or is tne pnmary purpose of the collecten related to Federal education programs ? O ves No

26. Does the agency use samphng to se!ect resooridents or does the agency recommend or prescribe the use of sampung or statistical analysis by responcents? . O tes O Nu

27. Reguidtory authority for the informatien (obection .

CFR . or FR . or.other (specofy).

Atomic Energy Act of Paperwork Certificattan _19 1 _as_amende_d In sute !! rf t*i s request for of.*H meeva, te e gerity tean. the serwr c'N at cr ar. autocr2ec rreresentat.ve. cert.t.es tha. the reamremer ts of 5 CFP D20 t' -

Ehv8C y 4e ! SI?bstca! standards e r rNer}.s < ed ah, ettc' ,fM atue m*vr.y' fr W r. i e #Mtm t..ne bf'en r nmphed wet's s, o. ,,, ,.m e ..i , t .c.

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w.u. m, , s , r, . . r w, ~wre +ve*'"" Date t

nC Patricia G. Norry, Director. T fice of Adminis,tration F Am. p ~

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SUPPORTING STATEMENT FOR NRC F0lM 212A, "QUALIFICATIONF INVESTIGATION, CLERICAL / SECRETARI AL"

1. JUSTIFICATION

a. Need for the Information Collection Information requested on NRC Fom 212A is used to detemine the qualifications and suitability of applicants for employment with the 1 l'.S. Nuclear Regulatory Commission. The completed fom may be used to examine, rate and/or assess the prospective employee's qualifica-tions. The information regarding the qualifications of applicants for employment is myiewed by professional personnel of the Division of Organization and Personnel, in conjunction with other infomation in the NRC files, to detemine the qualifications of the applicant for appointment to the position under consideration, j b. Practical Utility of the Information Collection 4

NRC Form 212A is sent to former employers, supervisors, and other references indicated on job applications as a part of the investi-gation for suitability of external candidates for appointment.

' The information obtained on NRC Fom 212A is reviewed and evaluated by personnel of the Division of Organization and Personnel in deter-

" lining the qualifications of applicants for employment.

c. nonlication With Other Collections of Information There are no alternative data sources which could be used to collect the infomation. Each response is for an individual applicant applying for a particular position. Because of this, other refer-ences which may be on file by former supervisors for other types of positions would be inappropriate. However, it should be noted that where the NRC has recent references on file and the positions which the applicant applied for are similar, no additional references are requested.

2. DESCRIPTION OF THE INFORMATION COLLECTION

a. Number and Type of Respondents Two-thousand foms are completed annually by supervisors or fomer supervisors of external applicants who nave applied for employment with the NRC.

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b. Reasonableness of the Schedule for Collecting Information The schedule for collecting infomation is regulated by the need generated by employment vacancies.

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c. Method of Collecting the Information The method for collecting needed information is through use of NRC Form 212A. It incorporates the best principles of conservation of resources available because the completed form is transmitted via mail or telecon.

d. Record Retention Period There is no mcordkeeping requirement.

e. Reporting Period There is no reporting period required, the NRC Form 212A is requested prior to final hiring decision on best qualified candidates.

f. Copies Required to be Submitted When this form is completed, one copy is required. Three different individuals are requested to provide information about the named individual's qualifications as they relate to the performance or duties by the applicant.

3. ESTIMATE OF BURDEN

a. Estimated Hours Required to Respond to the Collection Past experience indicates that responding on this form takes about 15 minutes. The total estimated time to respond to the approximate 2000 forms used annually is 500 hours0.00579 days <br />0.139 hours <br />8.267196e-4 weeks <br />1.9025e-4 months <br /> (.25 hours2.893519e-4 days <br />0.00694 hours <br />4.133598e-5 weeks <br />9.5125e-6 months <br /> x 2000 forms).

b. Estimated Cost Required to Respond to the Collection The estimated annual cost to respond to the information requested is

$30,000 (500 hours0.00579 days <br />0.139 hours <br />8.267196e-4 weeks <br />1.9025e-4 months <br /> x $60/ hour).

4. ESTIMATE OF COST TO THE FEDERAL GOVERNMENT t

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The total estimated annual cost to the Federal Government for printing, handiing, reviewing, and assessing the NRC Form 212A is $12,000 (200 hours0.00231 days <br />0.0556 hours <br />3.306878e-4 weeks <br />7.61e-5 months <br /> x $60/ hour).

Enclosure:

NRC Form 212A l

NnC F O RM 212 A U S. NUCLE AR RE GU L ATOR Y COvv eSSION CATE H,0y ( - 4) APPROVED BY OYB NnCV 4171 3150 0034 QUALIFICATIONS INVESTIGATION I ' t " ' "' 7' a N 8 ' ' ''

The applicant named twton has applied for a secretarial / clerical position in the NRC. Please rate the applicant against the items beinw in respect to the period of Isme you either supervised or were personally acquainted with the applicant. Include any comments you may f eel are relevant Please retur n the completed form to me by the return date endicated above, sealed in the enclosed envelope and marked for Addressee On/v.

APPLiC ANT'S N AME TO:

POSITION APPLIE D 5'OR FROM:

PERSONNEL M ANAGEMENT ANALYST L J DIVISION OF ORGANIZATION AND PERSONNEL U.S. NUCLEAR REGULATORY COMMISSION WASHINGTON. DC 20555 This form es used for investigating the qualifecations of external candidates for appointment. Items 19, 20 and 21 g y M may be used by the Personnel Management Analyst when additeonal items are required. The candidate should not 9 y4 4 $

be rated on those stems which have been lined out by the Personnel Management Analyst as not applicable E Oc E Sw

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1. QUALITY OF WORK.

2 AMOUNT OF WORK PRODUCED.

3 TYPING

4. SHORTH AND

5. EFFECTIVE USE OF EQUIPMENT MATERI ALS AND TECHNIOUES RE LATE D TO WORK.

6. THOROUGHNESS AND OBJECTIVITY IN CARRYING OUT WOR K.

7. ABILITY TO IDENTIFY PRIORITIES AND ORGANIZE WORK.

8. ABILITY TO MEET DE ADLINES

9. OF FICE SKILLS (Filing, photocopveng. answering phones, etc.).

10. ABILITY TO ESTABLISH EFFECTIVE WORK RE LATIONSHIP WITH-a CO WOR KE RS.

b. HIGHER LEVE L OFFICIALS.

c. REPRESENTATIVES OF INDUSTRY OR OTHER GOVERNMENT AGENCIES.

11. OR AL E X: k '.SSION.

12 WRITTEN E XPRESSION.

13. ADAPTABILITY.

14 DEPENDABILITY.

15. INITIATIVE 16 CRE ATIVITY.

17. ABILITY TO WORK EFFECTIVE LY IN STRESSFUL SITU /.T8 NS.

18 WORK AND PERSONAL HABITS.

19 20 21.

22. HOW WOULD YOU RATE APPLICANT sN REGARD TO POTENTI AL FOR FILLING JOB FOR WH CH APPLIED) 23 WOULD YOU REHIRE THIS CANDIDATE) O yts O No

24. RELATIONSHIP TO APPLICANT LJ SUPERVISOR O CO-WORKE R O PROFESSIONAL 0 OTHE R (Specif y)

AODITION AL COMME NTS (Please continue on reverse.)

NOTE Consister,t with the Priva y Act o' 1914, this evaluation my be reveatal to the applicant upon his or her reep,est Howe v er , if you request . your irtent tv ..orf other <sentit eng infr;rnwt ron will tm b ept conf af*ntial P!aase intbt ate beiow whether you nestre yo se inent,tv to t>e b ept contaiential

[] MY IDENTITY MAY BE HE VE ALED C i HE OUEST MY IDENTITY BE KE PT CONFIDE N TI AL SIGN A t u Rt o r i l-N R C F O R M 212 A (1 C

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