ML20133Q146

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

ML20133Q146
Person / Time
Issue date:	10/28/1985
From:	Norry P NRC OFFICE OF ADMINISTRATION (ADM)
To:
References
NUDOCS 8511010405
Download: ML20133Q146 (5)

Text

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ste.~d re,m 83 Costined Ma nj W. 'cem

. . < , ~ Request for DMB Review ^

impeetant Read instructions before completing form. Do not use the sane SF 83 to request both an Executive Order 12291 review and approvat under Send th.'ee cop 6es of this form, the material to be revwwett, and for the Paperwork Reduction Act paperworsthree copies of the supporting statement, to Answer all cuestx>ns m Part If tt"s request is for review under E.O. Office of Information and Regulatory Af f airs 12291, complete Part 11 ard sign the regulatory certification. If this Of fice of Management and Budget rgquest is for approval under tne Paperwork Reduction Act and 5 CFR Attention Docket Library, Room 3201 1320, skip Part ll, complete Part th and sign the paperwork certificat,on. Washington, DC 2o503 PART l.-Complete This Pert for All Requests.

1. Departmentlage9Cy anQ Bur eaur cif+ce or;gtnatir4 rect.eSt T 2. A .ency (Ode t

U. S. Nuclear Regulatory Commission 3_

3. fearne cf person who Can best answer Questions regarding this rebest

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Teiephone number Mike Callahan

d. Titto of inforrnation conecteor: or rulemaking < 301) 492-8263 NRC 212, Qualifications Investigation, Professional

5. Legal authority for sntormatson conection or rule (cite U&ea States Coce. Pubhc taw, or Executwe Orderl

__ 42 .usc 2201(o) ,,

6. Affected pubhc(check allthatapp/v)

$ Q Federa'agenciesor emotoyees 1 3 indmdvais or households 3 O Farms 6 0 Non-profit institutions 2 O stateoriocar so, <nments 4 0 Bus.nesses or other vor profit 7 O smatibusinesses or organisatons PART ll.-Complete This Part Only if the Request is for OMB Review Under Executive Order 12291 E Aegulation Icer tif er Nurrber(RIN)

- - - - - _ _ . cr, None assqgned b

8. Type of submess*on (check or'e un each category)

Classificattorr Type of review requested Stage of development 1 O standard i O uator i O eroposedor draft 2 Wonmajor 2 O Pending 2 O r.naio inter 1m t.na:. -in or,or p coosai 3 O trrergency 3 0 Fra or u.te-r i f.na!.

• thout pror prognas 4

9. CF R section affected statutort or sudoai deaene CFR 10.aed Oces5 CFRthis1320' regulation crWam reyntmg c: re.crduep.nu +quoen

• nts inat wou>re CMB approval under the Paperwork Reduction At t

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11. If a rna.u ru e. is there a reru atcry ,mex t a%,es c"achec' e 'No." oc OMb w.me t e anaw 1ow C No 3 [] w .: , jrr Certification f or Regulatcry Submissions hDY in psubmitting in>> ree..

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fu OME o v em tu + tW.x n rwtm w';.a n:tw :. mrwn t 'tos r e t t, " .et the r. r o e".- < t ') :W a 4 m.,,'>v-6 I'*N #

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PART lll.-Camplettihis Part Only if tha Rsqu:st is f:r Appravtlcf a Calltctirn of Information Under the Paperwork Reduction Act and 5 CFR 1320.

j 13. Abstract-Desenbe nceds. uses and af fected pubnc m 50 words or iess

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

14. Type of information conecten (check only one) information collections not contained in rules 13 Regular submission 2 c mergency submissen (certi6 cation attached)

Inforte stion collections contained in rules 3 0 .1isting reguratien tno chanse proposed) e rinai or intenm finai witneut pnor neRu 7. cnter date oe e pected or actuai rede,ai 4 0 eiotice of p<rposed ruiemakins tupau) A O Regular submission Register put* cation at this stage of rulemaking 5 0 r.nai. seau was previousry pubiished 8 cmergency submission (cert,6caten attached) (month, dar. rear 1

15. Type of review requested (check only one) 1 O sew coiiection 4 O Reinstatement of a previously approved collection for which approval 2 O Revision of a currently approved collection h**D"'d 3 @ Extensen of the expiraten date of a currently approved collection 5 Existing collection m use without an oMB control number without any change en the substance or in the method of collection

16. Agency report form numberts)(onclude standard /optoonal form number (s)) 22. Purpose of mformation coniection (check as many as apply) 1 Application for benefits NRC 212 2 Program evaluaten

17. Annuat reperting or d:sclosure burden 3 0 ceneraipurpose statistics 1 Number of respondents . 2,000 4 p,goi,to,yo,com ,,,,ne, 2 Number of responses per respondent l 5 O Progra.vi pianningor management 3 Total annua! respor'ses (t.ne 1 times hne 2; 2,000 6 Research 4 Hours per response .25 7 O Audit 5 Totml hours (hne 3 t>mes hee 4) 500

18. Annualrecordkeepmgburden 23. F requency of recordkeeping or reportmg (check aff that apply) 1 Number of recordkeepers NA 1 Recordkeeping 2 Annual hours per recordkeeper. Reportisq 3 Total recordkeeping hours (hne 1 times hne 2) 2 on occasion 4 Recordkeepmg retention penod years a O weekry

19. Totti annual burden 4 Monthly 1 Requested (hne 17 5 plus hoe 18 3) . 500 s O ovarteriy 2 in current oMB m<entory 500 6 setni.annuany 3 Difference (hne f les t Ane 2) 0 7 O Annuaiiy Esplanation of difference 8 O Boei.nsally 4 Program change 9 Other(desenbe) 5 Adjustment .

20. Current (most recent) OMB control number or comment number 24. Respondents

• obligation to compty (check the strongest obligation that stiphes) 3150-0033 I SD voiuntary

21. Requested experation date 2 O Required to obtain or retam a benea

12/31/88 3 0 Mandatory

25. Are the responcents pnmaroy educational agencies or instrtutions or rs the pnrnary purpose of the conecten reisted to rederal education programs? Yes Q No

26. Does the agency use sampheg to seie(t responder'ts or does the agency recommend or prescnbe the usa of samphng or statistical ana!ysis by responder'ts? . O ves O,( No

27. Regulatory author.ty fcr tne iriformation cotiection Cf R  ; or rR . or,of her (spectfy) Atomic _ElleEgy_ACt_0f 1954, as amended Paperwork fertifwatien in ute tt y

• 5 rn w 'r ' 'Mi .wr% tr<e rp w, t.caq. tre se ce of % W c' an secr14 re prewnrative certitets tt a' the reveerne% of 6 U P IMO tN Irtir y f r '. W ' '.* f a 'rMA s ( . r a e. ' s ,+ C o % ' t* 8" 4f fi d be tr k t ' uC" rm s . r* rf t# ' w hM.= r * *'t r cre(' bed w tth sn o,, ~ m - - - - - - - - ~~

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I wr e m . , ~.. .o . , - oru n u w .- oen,esem.m . - - d re i

Patricia G. Norry, Director, Office of Administr3M8n

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. s SUPPORTING STATEMENT FOR NRC FORM 212

" QUALIFICATIONS INVESTIGATION, PROFESSIONAL"

1. JUSTIFICATION

a. Need for the Information Collection Information requested on NRC Form 212 is used to determine the qualifications and suitability of applicants for employment with the U.S. Nuclear Regulatory Comission. The completed form may he used to examine, rate and/or assess the prospective employee's qualifications. The infomation regarding the qualifications of applicants for employment is reviewed by professional personnel of the Division of Organization and Personnel, in conjunction with other information in the NRC files, to detemine the qualifi-cations of the applicant for appointment to the position under consideration.

b. Practical Utility of the Information Collection NRC Fom 212 is sent to former employers, supervisors, and other references indicated on job application: as a part of the investi-gation for suitability of external candidates for appointment.

The information obtained on NRC Fom 212 is reviewed and evaluated by personnel of the Division of Organization and Personnel in deter-mining the qualifications of applicants for employment.

c. Duplication With Other Collections of Information There are no alternative data sources which could be used to collect the information. Each response is for an individual applicant applying for a particular position. Because of this, other references 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 addi-tional references are requested.

2. DESCRIPTION OF THE INFORMATION COLLECTION

a. Number and Type of Respondents t Two-thousand (2000) forms are completed annually by supervisors or {

former supervisors of external applicants who have applied for  !

employment with NRC.

b. Reasonableness of the Schedule for Collecting Information The schedule for collecting information is regulated by the need '

generated by employment vacancies. '

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c. Method of Collecting the Information The method for collecting needed informat on is through use of NRC Form 212. 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 recordkeeping requirement.

e. Reporting Period

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

I 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 The total estimated annual cost to the Federal Government for printing, handling, reviewing, and assessing the NRC Form 212 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:

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NRC Form 212 l l

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NRL M e171 APPROVL O HY OMH 32 W Oo33 OUAllFICATIONS INVESTIGATION RETURN SY: (011)

The appHcont named t esow hee opplied for e position in the NRC Please rete the applicent against the items below in roepect to the period of time superused or were acqueented auth the applicant, include any comments you may feel are re6ewnt. Please return the completed form to me by the return dote indicated above, see6ed in the enclosed envelope and merked for Addnpssee On/r.

APPLIC ANT'S N AME TO:

{ POSITION APPLIED FOR FROM:

PERSONNEL MANAGEMENT ANALYST L d OlVISION OF ORGANIZATION AND PERSONNEL U.S. NUCLEAR REGULATORY COMMISSION WASHINGTON, DC 20555 T his form la used for inwetigating the qualifications of ortemel car'didates for oppointment. Iteme 22,23, and b

$ usb RU E 24 may be used by the Personnel "tvg.; Anotyst sehen additionalitems are required. The candidete should E stot be reted on those 6tems seNch hees been lined out by the Personnel am. ..; Analyst es not applicable.

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1. TECHNICAL COMPETENCE.

2. E FFECTIVENESS IN MAKINC DECISIONS OR RECOMMENDATIONS.

3. ABILITY TO COMPREHEND PROBLEMS.

4. EXTENT TO WHICH EMPLOYEE KEEPS ABREAST OF NEW DEVELOPMENTS.

5. EFFECTIVE USE OF EQUIPMENT, MATERf ALS AND TECHNIQUES RELATED TO WORK.

6. THOROUGHNESS AND OBKCTIVITY IN CARRYING OUT WORK.

7. ABILITY TO IDENTIFY PRIORITIES AND ORGANIZE WORK.

8. ABILITY TO MEET DEADLINES.

9. AULITY TO SUPERVISE. .

10. AIf LITY TO ESTABLISH EFFECTIVE WORK RELATIONS.tlPS WtTH:

e. SUSOR DIN ATES.

6. CO-WOR KE RS.

c. HIGHER LEVEL OFFICIALS.

d. REPRESENTATIVES OF INDUSTRY OR OTHER GOVERNMENT AGENCIES.

11.C;:AL EXPRESSION.

12. WRITTEN EXPRESSION.

13. ADAPTA81LITY.

14. EFFECTIVENESS IN TRAINING AND DEVELOPING SUSORDINATES.

16. DE PEND ABILITY.

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16. QUALITY OF WORK.

17. lNITI ATIVE.

18. CRE ATIVITY.

19. AMOUNT OF WORK PRODUCED.

20. ABILITY TO WORK EFFECTIVELY IN STRESSFUL SITUATIONS.

21.WOT.K AND PERSONAL HABITS.

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23.

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5. HOW WOULD YOU RATE APPLICANT IN REGARD TO POTENTI AL FOR FILLING JOB FOR WHICH APPLIED?

26. WOULD YOU REHIRE THIS CANDIDATE 7 O YES O NO ADDITION AL COMMENTS triesse cont /nue on reversel NOTE:

Consistent with the Privecy Act of 1974, this evolustion mov tie revealers to the opplicant upon his or her request However, if you request, your identity and other identif ying 6nformation will the bapt contvjential. Ploese indicate below whether you desire your identity to be kept confidential.

O MY IDENTITY MAY BE HEVEALED. O i HEOUEST MY IDENTITY HE KE PT CONFIDENTI AL.

SIGN A TU RE t> A t E l

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