ML20246M039
| ML20246M039 | |
| Person / Time | |
|---|---|
| Issue date: | 03/16/1989 |
| From: | Amenta J NRC OFFICE OF INFORMATION RESOURCES MANAGEMENT (IRM) |
| To: | |
| References | |
| OMB-3150-0051, OMB-3150-51, NUDOCS 8903270023 | |
| Download: ML20246M039 (8) | |
Text
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'Duane G. Kidd 301 492-4124 PRC Form 277, Request for Visit or Access Approval i
Executive Order 12356 X
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.V OMB SUPPORTING STATEMENT FOR NRC FORM 277 Request for Visit or Access Approval 1
Description of the Information Collection The information collection associated with the NRC Form 277, " Request for Visit or Access Approval," affects any employee of approximately 22 licensees l
and 35 contractors who:
(1) holds an NRC access authorization; and (2) needs to make a visit to NRC, other contractors / licensees or government agencies in which access to classified information will be involved or unescorted area access is desired. The completed NRC Form 277 contains a signature certifica-tion of the NRC access authorization and of an official need-to-know. Only a minimal. amount of other identifying / pertinent information (e.g., date of birth, clearance type, dates of visit) are requested by the form.
' A records retention period of three years following the expiration of the visit by both the requesting and visited facility is required for the form.
Personal information contained on the completed form is handled and protected in accor-dance with the NRC directives and provisions of the Privacy Act of 1974.
Other information contained on, or pertaining to the form (e.g., recordkeeping and reporting requirements) is available for public inspection in accordance with 10 CFR Part 9.
The use of NRC Form 277 affords some assurance that only properly cleared and authorized individuals, who require access as a part of their official duties, will have such access during visits to other facilities and agencies. There-fore, the use of the NRC Form 277 benefits the NRC security program and public at large.
A.
JUSTIFICATION 1.
Need for Collection of Information.
Section 4.1 Executive Order 12356 states:
"A person is eligible for access to classified information provided that a determination of trustworthiness has been made...and provided that such access is r.ssential to the accomplishment of lawful and authorized Government purposes." Further, Section 5.3 requires agencies to "... establish procedures to prevent unnecessary access to classified informa-tion...."
The use of the NRC Form 277 as cited in Section 25.35 of 10 CFR Part 25 (applicable to licensees) and in NRC Management Directive 2101, Part IX (applicable to contractors) is the method by which NRC can provide assurance of compliance with the above provisions of E.0.
12356. The NRC Form 277 provides the facility / agency to be visited with verification of the visitor's NRC access authorization and certi-fication of their official need-to-know for the classified information
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regarding the visit.
By requiring the information collection con-tained on the NRC form 277 the facility / agency can assure that only properly cleared and authorized individuals will be permitted access during a visit.
L 2.
Agency Use of I_nformation.
The NRC Form 277 is forwarded by the licensee / contractor through the appropriate NRC off4ce exercising oversight, licensing or J
regulatory authority for certification of need-to-know to the NRC Division of Security (SEC). After clearance verification, SEC j
forwards the completed form to the security office having cognizance q
over the facility to be visited. The security office of the faci-lity being visited uses the information collected to confirm iden-tity of the visitor and to permit the visitor access to the re-quested ciasified information/ area. Failure to use the NRC Form 277 by th> licensee / contractor may result in denied access to classified information or areas which are necessary in the accom-plishmcnt of official duties.
3.
Reduction of Burden Through Information Technology.
No reduction in the information collection burden can be realized through informat wn technology with respect to the NRC form 277.
The informatio >.untained/obtained on the form is visit specific.
Also, original signatures are necessary for access authorization verification and need-to-know certification.
4.
Effort to Identify Duplication.
In order to safeguard classified inforr uion, other Government agencies and certain facilities collect information of a nature similar to the NRC Form 277, to verify the access authorization and confirm the need-to-know of visitors. The information collec-tion on a given NRC Form 277 does not duplicate or overlap other information collections made by the NRC or other Government agencies since each visit /acce,s approval is unique. With respect to the actual form, essentially identical forms are used throughout the U.S. Government, yet there is no standard form available.
- Instead, there is reciprocal acceptance of the forms among facilities /
agencies.
5.
Effort to Use Similar Information.
There is no similar information collection made by NRC or any other Government agency which could be utilized, since each visit approval is unique and requires the establishment of specific permissible accesses for the visit.
6.
Effort to Reduce Small Business Burden.
None of the licensees affected by the use of the NRC Form 277 qualify as small business enterprises or entities. ;
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7.
Consequences of Less Frequent Collection.
The frequency of information collection is dependent on the num-ber of visits an individual makes to Government agencies or facilities.
In most cases, a less frequent collection would mean eliminating the collection, as visits by-contractors / licensees, for which the NRC Form 277 would be required, are' infrequent.
If the information is~not collected, access by the visitor to classified information or areas, necessary in the accomplishment of official duties, may be denied. Further, a reduction in the collection of the information required by the NRC Form 277 would reduce the assurance that only properly cleared and authorized individuals will be permitted access during a visit. Thus, less
. frequent collection may endanger the U.S. common defense and natienal security.
8.
' Circumstances Which Justify Variation from OMB Guidelines.
There is no variation from OMB Guidelines in the collection of information.
9.
Consultation Outside the Agency.
No consultations were conducted since the last clearance submittal.
10.
Confidentiality of Information.
The information collected is used to establish the permissible access associated with a visit for an individual. The information is protected from public disclosure under the Privacy Act of 1974 and is handicd in accordance with routine uses specified in the Privacy Act Statement contained on the form.
11.
Justification for Sensitive Questions.
NRC does not request sensitive information on this form.
12.
Estimated Annualized Cost to Federal Government.
The estimated annual cost to Federal Government associated with the NRC Form 277 is $263.06. This cost was computed as follows:
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NOTE: Annual form usage for NRC licensees / contractors is estimated-as 30.
COSTS:
$100.00 Annual clerical effort
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(30 X 10.00 minutes = 5.0 hrs. X $20/hr.)
150.00 Annual professional effort
=
(30 X 5.00 minutes = 2.5 hrs. X $60/hr.)
- Annual record holding (3 yrs.) =
13.06 (1/16 cu. ft. X $209/cu. ft.)
Total estimated annual cost =
5263.06 13.
Estimate of Burden.
The total estimated annual hours of burden to the public (based on the past staff experience) associated with the llRC Form 277 is 5.0 hours0 days <br />0 hours <br />0 weeks <br />0 months <br />. The total estimated cost to the public for use of this form is $313.06. These totals were computed as follows:
Burden-Hours Cost 30 annual responses X 10 minutes 5
$300.00 per response Recordkeeping (3 years) 5 13.06 Totals 10
$313.06 14.
Reasons For Change _in Burden.
The burden associated with recoraxeeping was understated in the current clearance and is being adjusted to reflect present burden.
15.
Publication for Statistical Use.
There is no application of statistics on the information collection related to NRC Form 277. There also is no publication of the information.
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- The NRC Form 277 must be retained for three years following the expiration date of the visit authorization to permit periodic survey. _ _ - _ _ _ _ _ _ _ _ _ _ _ _ _ _
,r-NRC FORM 277 Approved by OMB g (,p UNITEo STATE S NUCLEAR REoVLATORY COMMIS$10N 31504051.
""I"1 gi, REQUEST FOR VISIT OR ACCESS APPROVAL
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(Not to be used for temporary or permanent personnel assignments PART "A" Date:
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Prepared by:
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Symbol:
1 Telephone No. (commercial or FTS):
it is requested that the following person (s) be granted visillaccess approval:
CHECK LAST N AM E, FIRST N AM E, MIDDLE INITIAL DATE OF AND us ORGANIZATION cEEan CLEARANCE DAT E OF Pt B RTH NO.
CLEARANCE SOCIAL SECURITY NUMBER CiTg ALIEN aseg g
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NAME OF FACILITY (!ES)TO BE VISITED; FOR THE INCLUSIVE DATES NRC Secufdy Official Venf y*0 NRC Clearance i
FOR THE PURPOSE OF:
TO CONFER WITH THE FOLLOWING PERSON (S):
SPECIFICINFORMATION TOWHICH ACCESSIS REQUESTED:
Access requested to:
Restr'cted Data C Yes O No Other Classified info !JYes R No Prtrr arrangements havelhave not been made as follows:
CERTIFICATION FOR PERSONNEL HAVING DOD CLEARANCE This certifies that the person (s) named above needs this access in the performance of duty and that permitting the above access willnot endanger the common defense and security.
Name and Title, Requesting DOD Officsal
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Title, Authorizing DbTOtticoa!
Signature (See DOD Directive 5210.2)
CERTIFICATION FOR PERSONNEL HAVING NRC CLEARANCE This certifies that the person (s) named above needs this access in the performance of duty.
Title Requesting NRC or DOD Offacial
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PART "B" Approvalis g' anted with limitations indu'cated below:
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l A uthorszed Official (Name and Ittle)
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PRIVACY ACT STATEMENT Pursuant to 5 U.S.C. 552a(e) (3), enacted into law by section 3 of the Privacy Act of 1974 (Public Law 93 579),
Lthe following statement is furnished to individuals who supply information to the Nuclear Regulatory Commission en NRC Form 277. This inform'ation is maintained in a system of records designated as NRC 39 and described'at 40 Federai Register 44533 (September 26,1976).
Sections 145 and 161(i) of the Atomic Energy'Act of 1954, as amended (42 U.S.C. 2165-AUTHORITY l 1.
and 2201(i)), and Executive Ordar 12356. Solicitation of the social security number is authorized by Execu.
tive Order 9397 dated November 22,1943.
2.
PRINCIPAL PURPOSE (S)
Information entered on this form is used to verify an individual's security clear-ance and authorization for access during a classified visit.
The information is provided to the contractor, licensee or other organization or individual ROUTINE USES 3.
to be visited. The information may also be disclosed to an appropriate Federal State, or local agency in the event theinformation indicates a violation of law and in the course of an administrative or judicial proc' eding, e
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in addition, this information may be transfrered to an appropriate Federal, State, and local agency to the ex-tent relevant and necessary for the NRC decision or to an appropriate Federal agency to the extent relevant and necessary for that agency's decision about you.
WHETHER DISCLOSURE IS MA'NDATORY OR VOLUNTARY 'AND EFFECT ON INDIVID 4.
PROVIDING INFORMATION lt is voluntary that you furnish the requested information. lf the information is not fornished, you may be denied entrance and/or access to the agency or facility and theinformation to which access is requested. Your social security number is used as an identifier due to the large number of in-dividuals with similar names and birth dates.
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SYSTEM MANAGER (S) AND ADDRESS Director, Division of Security Office of Administration
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