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Request for OMB Review & Supporting Statement Re NRC 212A, Qualifications Investigation,Clerical/Secretarial. Estimated Respondent Burden 375 H
	ML20246M025
Person / Time
Issue date:	03/16/1989
From:	Amenta J; NRC OFFICE OF INFORMATION RESOURCES MANAGEMENT (IRM)
To:	;
References
	OMB-3150-0034, OMB-3150-34, NUDOCS 8903270018
	Download: ML20246M025 (7)
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FART lif -Complete This P:rt Onlyif the Requist is for Appr v:Icf a CallIcti:n of info'mation Under the Paperwork Reduction Act and 5 CFR 1320.

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n Awd--oeuae neces. t.ses ane atfected pubac in So words or iess og g ) gg gg gg gg u

Information requested. is used to determine qualifications and suitability of applicants for employment in clerical / secretarial positions with the NRC.

14'; Tge et nrecmr e t 8e:dce- (chec A on'y o,c)

Infarroa ho 1 c ollections act cortairzed let rules 13 F*ght sucmissien 2 O tmergency submission (cerr,i, cation, tract'ed)

' infortnation collectioits contained in rules 3 C Esist:ng reguaticn (;>c charge proposed) 6 final or intenm final without prior NPRM

7. Enter date of expected or actual Federat 4 U fct':e o' p'cposed rueraakirg(NPRM)

A Regular submission Register pubhcation at this stage of ruiemakirtg 5 C Fir.el. r#RM wts pronous:y pvbrshed B O Emergency submission (certification attached)

(month, day, year)

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15. Ige of revmw reaped (Chec4 odiy one)

~ l C Ne y re'iectior 4 C Reinstatement of a previously approved collection for which approval

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has expired 2 C tecs eq of a crenty approved coHectron 3 3 Exte.s on o: tr e eeneter. ca'e of a currently approved collection 5 O Existing collection in use without an oMB control number mit out en, c-we m the substerce or in the method of collection it. r po: et:nt *urm nuv~cen s)(wude sfanja d/ optional form number (s))

22. Purpost of information collect >on (check as tna1y as apply)

NRC 212A 1 G Appacanon for benefits l

2 C ProEram esalvation iL M nur te;ert'r f er $sc'csu*e Wede' 3 C Generar purpose statistics 1.500 4 0 Pessatory or comptance i te te c?ewoN!ents.

2 Nhe cf resoo" ses ;er resso,ce-t, 1

5 C Program p'anningor ma,agement 3 T-13:nau eswsn (! ne 1 trots ime 2) 1.500 6

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23. Frequency of recordkeeping oi eporting(check alithat applyf 1 NJoet cf rearcieepers 1 C Recordheeping 2 t % hcts ;e* rec *teeper Reporting

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2 @ On o:casion e racer:wpmg em ;enca years 3 [ %,y a veristnae:b reen 4 C Montnty 375

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5 0 Quarterli 500 6 0 semi a,nuany 2E :vr+en:OME.r,e nory 3Neter ;e ; < e J ts m.,

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9 Colt'W r'u"ter or cc rment numbar

24. Responcentf obhgation to cor ply (checA the strongest othgation that apches) 3150-0034 3 g yommar,

21. Rtwetec emah'e 2 O pecuiree to oetain or retam a benefit 2/27/92 3 C uannato y 7b. A re if e res;$rdenti es cr.'t ecucat>cnal ase'icies or institutions or is t.Se pnmary purpose of the collection related to Federal education programs? C Yes @ No 2R Doe'; t' e arcy w$e u mpug to se eet respcr:cer<ts or does the agency recomn.end or prescribe tr+ use of sarnpung o statist cal ana!ysis C Yes 30 No by.'es;reem' F% fatory (M or '

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Ir secrj tys re;uest f:: ouB approval, tne agency head, the senior offic al or an authonged representative, certifies that the re:W rernents of 5 CFR 1320. the Frwec, Ac t, substice ta'icards or d.re:tives, ard any other apphcable information pobcy directives have been comphed wrth

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SUPPORTING STATEMENT For NRC Form 212A, " Qualifications Investigation, Clerical / Secretarial" (0MB Clearance No.- 3150-0034)

Description of Information Collection This form is used for investigating the qualifications of external candidates for appointment to clerical / secretarial positions in the Nuclear Regulatory Commission (NRC).

A.

Justification 1.

Need for the Collection of Information Information requested on NRC Form 212A is used to determine the qualifications and suitability of applicants for employment in clerical / secretarial positions with the U.S. Nuclear Regulatory Commission. The completed form may be used to examine,. rate and/or assess the prospective employee's qualifications. The information regarding the qualifications of applicants for employment is reviewed by professional personnel of the Office of. Personnel, in conjunction with other information in the NRC files, to determine the qualifications of the applicant for appointment to the position under consideration.

2.

Agency Use of Information NRC Form 212A is sent to former employers, supervisors, and other references indicated on job applications as a part of the investigation for suitability of external candidates for appointment to clerical / secretarial positions. The information obtained on NRC Form 212A is reviewed and evaluated by personnel of the Office of Personnel in determining the qualifications of applicants for employment.

3.

Reduction of Burden Through Information Technology There are no legal obstacles to reducing the burden associated with this information collection through the use of information technology. The nonrecurrence of each individual collection makes it difficult to reduce the burden through the use of technology.

However, the NRC encourages the respondents to use any innovative technology which would reduce burden.

4.

Effort to Identify Duplication Where the NRC has recent references on file and the positions which the applicant applied for are similar, no additional references are requested.

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, 5.

Effort to Use Similar Information This information is available only from the individual rater.

6.

Eff_ ort to Reduce Small Business Burden Information may be requested from individuals associated with small businesses; however, the amount of information requested is kept to a minimum while still allowing a full investigation.

7.

Consequences of Less Frequent Collection This information has to be collected and reviewed prior to making a decision on employment eligibility.

8.

Circumstances Which Justify Variation from OMB Guidelines This raquest does not vary form':0MB guidelines.

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9.

Consultations Outside the NRC_

There were no consultations outside of NRC.

10. Confidentiality of Information NRC provides no pledge of confidentiality of the evaluation.

However, confidentiality of the name of the rater will be honored upon request, and the form provides for making such a request.

11. Justification for Sensitive Questions I

Not applicable.

12. Estimated Annualized Cost to the Federal Government 1

The total estimated annual cost to the Federal Government for printing, handling, reviewing),andassessingtheNRCForm212Ais

$9,000(150 hours0.00174 days 0.0417 hours 2.480159e-4 weeks 5.7075e-5 months x $60/ hour

13. Estimate of Burden and Cost to Industy Past experience indicates that responding on this form takes about 15 minutes. The total estimated time to respond to the approximate 1,500 forms used annually is 375 hours0.00434 days 0.104 hours 6.200397e-4 weeks 1.426875e-4 months (.25 hours2.893519e-4 days 0.00694 hours 4.133598e-5 weeks 9.5125e-6 months x 1,500 forms).

The estimated annual cost to respond to the information requested is

$22,500 (375 hours0.00434 days 0.104 hours 6.200397e-4 weeks 1.426875e-4 months x $60/ hour).

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14. Reasons for Change in Burden Reduced recruiting effort by NRC commensurate with a reduction in the FTE ceiling has reduced the number of anticipated responses from 2,000 to 1,500 per year with a corresponding reduction in burden.

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15. Publication for Statistical Use Information gathered is not published.

B.

COLLECTION OF INFORMATION EMPLOYING STATISTICAL METHODS Statistical methods are not used in this information collection.

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Enclosure:

i Sample NRC Form 212A i

._________.-_____-_A

a DNE U.S. NUCLE AA F;EOULAToltY COMMISSION NRC FOh.M 212A' APPACVED SY OMll g g a, g g EXPlRE5 RETURN SY (Dete)

QUALIFICATIONS INVESTIGATION The tpplicant narned below has spolied for a secretarial / clerical position in the NRC, Please rate the applicant against the items below in respect to the period of tlrne you either supervised or were personally acquainted with the applicent, include any comrnents you may feel are relevant. Please return the completed form t3 me by the return date Indicated above, sealed in the enclosed envelope end rnarked for Addressee Only.

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APPLICANT'S N AME

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TO:

POSITION APPLIED FOR FROM:

PERSONNEL STAFFING SPECIALIST l

l OFFICE OF PERSONNEL

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J U.S. NUCLEAR REGULATORY COMMISSION j

WASHINGTON, DC 20656 I

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This form is used for investigatingtg allgign; of external candidates for appointment. Items 19,20 and 21

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may be used by the Personnel Sn;-- "

et when additiona be rated on those items which have been lined out by the Personnel hgt,t7g orgrgi ed. The candidate should not f

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l 1. QUALITY OF WORK.

I 2. AMOUNT OF WORK PRODUCED.

3. TY PIN G.

4. SH O R THAN D.

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

6. THOROUGHNESS AND OBJECTIVITY IN CARRYING OUT WORK.

7. ABILITY TO IDENTIFY PRIORITIES AND ORGANIZE WORK.

8. ABILITY TO MEET DE ADLINES.

9. OFFICE SKILLS (Filing, photocopying, answering phones, est.)

10. ABILITY TO ESTABLISH EFFECTIVE WORK RELATIONSHIP WITH:

e. CO WORKE RS.

b. HIGHER LEVEL OFFIClALS.

c. REPRESENTATIVES OF INDUSTRY OR OTHER GOVE RNMENT AGENCIES.

11. ORAL E XPRESSICN.

12. WRITTE N E XPRES$10N.

13. ADAPTABILITY,

14. DE PEN D ABILITY.

15. INITI ATIVE.

16. CRE ATIVITY.

17. ABILITY TO WORK EFFECTIVELY 1N STRESSFUL SITUATIONS.

18."!O" G PCaC0? 24 : A '"!M

'M 2 // //r"9 19.

20.

21.

22. HOW WOULD YOU RATE APPLICANT IN REGARD TO POTENTIAL FOR FILLING JOB FOR WHICH APPLIED 7

23. WOULD YOU REHIRE THIS CANDIDATE?

O YES O NO

24.. RELATIONSHIP TO APPLICANT O SUPERVISOR O CO-WORKER O PROFESSIONAL O. OTHE R (Specify)

ADDITION AL COMMENTS (Please continue on reverse.)

NOTEt Consistent with the Privacy Act of 1974, this evaluation rnay be revealed to the applicant upon his or her request. However, if you request, your identity and other identifying information will be kept confidential. Please indicate below whether you desire your identity to be kept confidential, j

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O MY IDENTITY MAY BE REVE ALE D.

O l REQUEST MY IDENTITY BE KEPT CONFitsENTI AL.

1 DATE SIG N ATU RE 1

8eIC Fo"# 212A *ese (&- F ()

EsTIMAf t o suRDEN PE R RESPONSE To COMPLY WITH THis lNf oRM Af ton COLLECTION RioutfT HRg PoRWADo CoMulkis REGARDING suRDEN I:TIMAis To YHE RtCoRDs AND RE7 orts MANAGEMEpr7 sRANCH (Pa30) u s NUCLE AR RE ouLAf oRV CoMMi ON.Tv ASHINoToN. DC 20 bas. AND To TMs oFFICs oF MANAGEMINT ANo 8vDGet' rniaAma 4soutriae #4ed Ser sdfeadohD m AsHINGT oN. Oc 20M13 l-

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j ADDITIONAL COMMENTS (Cont,nura).

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PRIVACY ACT STATEMENT Futsuant to 5 U.S C. 552(a)(3), enacted mto law by Section 3 of the Priva:y Act of 1974 (Public Law 93 579), the followirig s*atement is furnished to individuals who supply information to the Nuclear Regulatory Commission on NRC Forms 212 and 212A. This information is maintained in systerrs of recorffs designated as NRC 1, NRC.11, and NRC 28 and described at 40 Federal Register 45333,45337, and 45344, respectively (October 1,1975).

1. AUTHORITY. Section 161(d) of the Atomic Energy Act of 1954,as amended 442 U.S C.22011d));and 5 US.C.1302.

2. PRINCIPAL PURPOSE (S). Information entered on this form is used to determine Qualifications and suitability of applicants for employment with the NRC. The completed form may be used to examine, rate, and/or assess the prospective employee's qualifications.

3. ROUTINE U5ES. None,

d. WHETHER DISCLOSURE IS MANDATORY OR VOLUNTARY AND EFFECT ON INDIVIDUAL OF NOT PROVIDING INFORMATION.

Completion of the form by all other individuals is voluntary; however, failure to supply the requested information may result in the individual not receiving full consideration for the potential job.

5. SYSTEM MANAGER (S) AND ADDRESS. Chief. Recruitmen affing ic ' _ : :, Office of Personnel, U.S. Nuclear Regulatory Commission, Washingion, D.C. 20555.

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ML20246M025

Text

Enclosure:

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