ML20137A452

Request for OMB Review Re Personnel Security Questionnaire. Estimated Respondent Burden Is 2,004 H

ML20137A452
Person / Time
Issue date:	08/13/1985
From:	Norry P NRC OFFICE OF ADMINISTRATION (ADM)
To:
References
OMB-3150-0048, OMB-3150-48, NUDOCS 8508210408
Download: ML20137A452 (2)

Text

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o 5"* * " 8 3 Request for 0MB Review Ge, Sevember 1981) l Important Read mstructions before compfeting form. Do not use the same SF 83

. Send three copies of this form, the material to be reviewed. and fi t3 request both an Executae Order 12291 review and approval under

• paperwork-three copies of the supporting statement. to.

j the Pape work Reduction Act.

Offree of Information and Regulatory Affairs r

Answer all questions in Part 1. If this request is for review under E.O.

Office of Management and Budget 12291. complete Part 11 and sign the regulatory certification. If this Attention: Docket Library, Room 3201 request is for approval under the Paperwork Reduction Act and 5 CrR Washington.DC 20503 1320, skip Part II. complete Part lit and sign the paperwork certification.

PART 1.-Complete This Part for All Requests.

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2. Agency code

1. Department / agency and Bureau /of f ace originating request 3 1 5 0 U.S. Nuclear Regulatory Comission Telephone number

3. Name of person who can best answer questions regarding this request 427-4761 Russell R. Rentschler (301 3

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4. Title of enformation collection or rulemaking NRC Form 1 - Personnel Security Questionnaire S. Legal authonty for mtormatson conectson or ruse (ct:e Unuted States Code. Pubhc Law, or becutive Order) 42 2201(o)

USC or 5 0 rederaiagencies or empioy. s

6. Affected public(check allthatapply) 1 O individuaisorhousehoids 3 0 rarms s O Non-profitinstitutions 2 O stateoriocaigovernments 4 D ausinessesor other vor. profit 7 O smaiibusinessesororganizations PART ll.-Complete This Part Only if the Request is for OMB Review Under Executive Order 12291

7. Regulation identif'er Number (RIN)

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or. None assigned O

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Type of renew requested

g. Type of submission (check one on each category) 1 O standard Cisssificat.'en v w. Stage of development 1 O unior 1 O Propos.dordraft 2 O Pending 2 O Non aio,-

, 2 O r.natorinterienrinsi.witner orproposai 3 O Emergency 3 0 rinaiorintenmainar.vnthoutpnarproposar 4 O statutoryorjudiciaidesdiine

9. CFR section attected CFR

10. Does this regulation contain reporting or recordkeeping requirements that require OMB approval under the Paperwork Reduction Act

. O ves D we and 5 CDt 1320?

1 O yes 2 O u-11.if a maior rule. is there a regulatory impact analysis attached?

3 0 ves ~4 0 n.,

If"No." did oMB waive the analysis?

Certification for Regulatory submissions in submitting this request for oMB review, the authorized regulatory contact and the program official certify that the requirements of E.O.12291 pohcy directives have been complied with,

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Date signatureof programettcal 8508210408 850813 PDR signature of authorized regulatory contact ORG EUSthB Dit' PDR

12. (oaf 8 use only) standare reem 8 3 gr. e :

Peevous editicas obso.ete 83 108 p.m..u..i t.. co h5N 75aOo0 63a a034 S Cr A 13:o au r 0. -

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e PART lli.-Cornplete This Ptrt Only if ths Rsquast is far Approval of a Callactirn of Inforrnation Under the Paperwork Reduction Act and 5 CFR 1320.

13 Abstract-oescribe needs, uses and affected pubhc in 50 wards or less A proposed amendment to 10 CFR Part 11 will permit MRC to use information already collected by other Federal agencies for similar access authorization programs.

This will result in a reduction in :;ubmissions of NRC Form 1.

14. Type of information collection (checA only one)

Information conections not contained in rules 10 Reeviar submission --

2 O Emergencysubmission(certificationattached)

Informstlen ceMeetions contained in rules 3 O Ea. sting reguistion(no change proposed) 6 rinai or interim final without prior NPRM

7. Enter date of espected or actual Federal 4 O Notice of proposed rulemaking(NPRM)

A U Regularsubmission Register publication at this stage of rutemak 5 O rinal. NPRM was previously published B O Emergency submission (certs/scation attached)

(month, day, year):

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15. Type of review requested (check only one) 1 O New collection 4 O Reinstatement of a previousir approved correction for which appr...

has expired 2b Revisionof acurrentlyapprovedcollection l

3 O E= tension of the e piration date of a currentir approved coii ction 5 O Existing coIIection in use without an OMB control number I

without any change in the substance or in the method of collection

16. Agency report form nutnber(s)(onclude standard /optionalform number (s)) -

22. Purpose of information coilection (check as many as apply)

HRC Form 1 1 O Application for benefits 2 O Programevaivation

17. Annualreporting or disclosure burden.

3 Genera' purpose statistics 1336-4 Regulatory or compliance l

1 Number of respondents.

f 5 O Program pia *g or management -

l 2 Number of responses per respondent I

6 O Research 3 Total annual responses (fine 2 times line 2)...

'b 7 O Audit 4 Hours per response EUU4 5 Totaf hours (tine 3 times line di

23. Frequency of recordkeeping or reporting (check att thatapply) 18.~ Annualrecordkeeping burden 1 O Recordkeeping I

1 umber of recordkeepers Reportins 2 Annual hours per recordkeeper.

3 Totai recordkeeping hours (line I times line 2) 2 $ Onoccasion l

4 Recordkeeping retention period yea'$

3 0 weekty l

19.Totalannual butden 4 O uonthiy

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2004 5

Quartetty 1 Requested (line J7 5plus Gne J83). *.-

6 Semiennually 1

2in current OMe inventory 3 Difference (fine Iless line 2).. '.

7 0 Annualiy l

Esplanatten efdifference 8 O Biennially I

9 0 Other(desenbe):

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4 Program change'.

+ 1081 l

5 Adiestment.

20. Current (most recent) OM B control number or comment number

24. Respondents' obligation to comply (check the strorqgest obligation that appl 3150-0048 1 O. voluntary 2 O Required to obtain or retain a benefit

21. Requested espiration date 3 years from approval date 3 [3 Mandatory

25. Are the respondents primarily educational agencies or institutions or is the primary purpose of the collection retated to Federa

26. ooes the agenef use sampling to select respondents or does the agency recommend or prescribe the use of

.. Oves O by tespondents i

on collection

27. Regulatgauthority for

• }f CFR

or FR

or. Other(specify):

1 Pc perwork Certification In submitting thes request for OMB approvat, the agency head, the senior official or an authorized representative. Cert 6fies that the requirements of l

Privacy Act, statistical standards or directives, and any other apphcable information poiscy directives have been comphed with.

Date S gnature of program official oafe S gnature of agency neao. the senior o f.cw or an awne:co representative r

Patricia G. Horry, Jirector

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[ 1 -ry-i 7

Office of Administration

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