ML20249A578

Request for OMB Review & Supporting Statement Re Qualifications Investigation Secreterial/Clerical.Estimated Respondent Burden 75 H

ML20249A578
Person / Time
Issue date:	06/09/1998
From:	NRC OFFICE OF INFORMATION RESOURCES MANAGEMENT (IRM)
To:
Shared Package
ML20249A244	List: ML20249A243 ML20249A574 ML20249A578
References
OMB-3150-0034, OMB-3150-34, NUDOCS 9806170092
Download: ML20249A578 (6)

Text

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4 PAPERWORK REDUCTION ACT SUBMISSION Please read the instructions before completing this form. For additional forms or assistance in completing this form, contact your agency's Paperwork Clearance Officer. Send two copies of this form, the collection instrument to be reviewed, the Supporting Statement, and any additional documentation to: Office of Information and Regulatory Affa;rs, Office of Management and Budget, Docket Library, Room 10102,72517th Street NW, Washington, DC 20503

1. Agency / Subagency originating request 2 OMB controt number U.S. Nuclear Regulatory Commission X a. 3150- 0034 b. None

3. Type of information collection (check onel 4. Type of review requested (check one/

a. New collection X a. Regular submission c. Delegated

b. Revision of a currently approved collection b. Emergency - Approval requested by (date):

X c. Extension of a currently approved collection 5. Will this information collection have a ,, ye, significant economic impact on a

d. Reinstatement, without change, of a previously approved substantial number of small entities? X b.No collection for which approval has expired

e. Reinstatement, with change, of a previously approved collection for which approval has expired Requested

a. e W ars a@ mal dam 6 expiration date

f. Existing collection in use without an OMB control number

7. Title NRC Form 212A, Qualifications investigation Secretarial /Cierical B. Agency form number (s) (if applicable)

NRC Form 212A

9. Keywords Qualifications, employment, investigation, human res >urces, appointment, hiring

10. Abstract Information requested on NRC Form 212A is used to ti etermine the qualifications and suitability of exterral applicants for employment in secretarial / clerical positit'ns with the NRC. The completed form is used by Human Resource Staffing Specialists of the Office of iluman Resources to examine, rate and/or assess the prospective employee's qualifications.

11. Affected pubhc IArart onmary with *P* and aM others that apply with *x*l 12. obhgation to respond Intern pnmary with *P* and an others ther applr\ with X*l \

P e. Individuals or households d. Farms P a. Voluntary l

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b. Business or other for-profit e . Federal Government b. Required to obtain or retain benefits

c. Not-for-profit institutions f. state. Local, or Tribal Govemment c. Mandatory

13. Annual reporting and recordkeeping hour burden 14. Annual reporting and recordkeepmg cost burden fin thousands of doAarsi

a. Number of respondents 300 a. Total annualized capital /startup costs 0

b. Total annual responses 300 b. Total annual costs lo&M) o

1. Perr:entage of these responses c. Total annualized cost requested o collected electronically 0 syi,

d. Current OMB inventory o

c. Total annual hours requested 75 e Difference o 75 f. Explanation of difference

d. Current OMB inventory

1. Program change

e. Difference

2. A,1justment

f. Explanation of difference

1. Program change

2. Adjustment l

I 15. Purpose of information collection 16. Frequency of recordiceeping or reporting (Check all that apply)

(Mark primary with *P* and all others that apply with *X*) a. Recordkeeping b, Third-party disclosure

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a. Application for benefits s. Program planning or management T c. Reporting

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f. Research 1. on accasion 2. Weekly 3. Monthly ts. Program evaluation

c. Genoiel pucpose statistics g. Regulatory or comphance .. .erly 5. semi-annually 6. Annually

d. Audit Benially

8. other (describel j

17, St 'tishca' wethnds 18. Agency contact leerson who can best answer questions repardits l'ie content of this submission)

Do A this information Miectgin errploy stat sticas methnos?

name: Jar; ice M. Clemens, OHR l l Yes X No Pnone; 301-415-1534 i 1

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NEM 10/95 POR ORG EUSOMB

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SUPPORTING STATEMENT For NRC Form 212A, " Qualifications investigation Secretarial / Clerical"

.(OMB Clearance No. 3150-0034)

Extension Request

. Description of information Collection This form is used for investigating the qualifications of external candidates for appointment to secretarial / clerical positions in the Nuclear Regulatory. Commission (NRC). This extension package reflects no change in the number of forms projected to be received by the NRC and no change in burden for the next three-year clearance period.

A. JUSTIFICATION

1. Need for and Practical Utility of the Collerdian of Inform =fian Information requested on NRC Form 212A is used to determine the qualifications and suitability of applicants for emp!oyment in secretarial / clerical 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 Human Resources, in conjunction with other information in the NRC files, to determine the qualifications of the applicant for appointment to the position under consideration.

2. Aaency Use of Information

-The 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 extemal candidates for appointment to secretarial / clerical positions. The information obtained on NRC Form 212A is reviewed and evaluated by personnel of the Office of Human Resources in determining the qualifications of applicants for employment.

3. Reduction of Burden Throuah Information Technoloav There are no legal cbstacles to reducing t_he 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 techr; ology. However, the NRC encourages the respondents to use any innovative technology which would reduce burden.

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4. Effort to identifv Duplication and Use of Similar Information Where the NRC has recent references on file and the positions which the applicant applied for are similar, no additional references are requested. The Information Requirements Control Automated System (IRCAS) was searched, and no duplication was found.

5. Effort 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.

6. Consequences to Federal Prooram or Policy Activities if the Collection is Not Conducted or is Conducted Less Frecuentiv This information has to be collected and reviewed prior to making a decision on employment eligibility.

7. Circumstances Which Justifv Variation from OMB Guidelines This request does not vary from OMB guidelines.

8. Consultations Outside the NRC ]

An opportunity to comment on the NRC Form 212A information collection requirements was published in the Federal Reoister on January 30,1998 (63 FR 4675). No comments were received.

9. Pavment of Gift to Respondents Not applicable.

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.

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11. Justification for Sensitive Questions i Not applicable. )

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12. Estimated Burden and Burden Hour Cost Past experience indicates that responding on this form takes about 15 minutes.

The total estimated time to respond to the approximately 300 forms used annually is 75 hours8.680556e-4 days <br />0.0208 hours <br />1.240079e-4 weeks <br />2.85375e-5 months <br /> (.25 hours2.893519e-4 days <br />0.00694 hours <br />4.133598e-5 weeks <br />9.5125e-6 months <br /> x 300 forms). The estimated annual cost to respond to the information requested is $9,375 (75 hours8.680556e-4 days <br />0.0208 hours <br />1.240079e-4 weeks <br />2.85375e-5 months <br /> x $125/ hours).

13. Estimated of Other Additional Costs Not applicable.

14. Estimated Annualized Cost to the Federal Government The total estimated annual cost to the Federal Government for printing, handling, reviewing, and assessing the NRC Form 212A is $9,375 (75 hours8.680556e-4 days <br />0.0208 hours <br />1.240079e-4 weeks <br />2.85375e-5 months <br /> x $125/ hour).

This cost is fully recovered through fee assessments to NRC licensees pursuant to 10 CFR Pads 170 and 171.

15. Reasons for Chance in Burden or Cost There has been no change in burden.

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

17. Reason for Not Disolavino the Exoiration Date The expiration date is displayed on form.

18. Exceotions to tFs Certification Statement Not applicable.

B. COI I FCTION OF INFORMATION EMPLOYING STATISTICAL METHODS Not applicable.

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NRC FORM 212A U.S. NUCLEAR REGULATORY COMMISSION APPROVED BY OMB: NO. 31604034 (MM YYYY) EXPIRES: MM/DD/YYYY NRCMD 101 Etameted burden per response to comply with the voluntary mformaton coilecbon request15 mmutes The mformaten is used to determine the quahficatons and suitabihty of external apphcants for employment Forward comments regardmg burden estimate to the Records QUALIFICATIONS INVESTIGATION w Management Brancit (T-6 F33), U S Nuclear Regula, tory Commission. Washm

. and io tre Paperwor* Reduct-a eroject (3 $o ooss>. O' rice or uaaaoemeni sad SECRETARIAUCLERICAL Budget, Washington, DC 20503 N an mformanon collection does not display a currently vehd OMB conWol number, the NRC may not conduct or sponsor and a person is not required to re.pand io, ch. informanon con. coon The applicant named below has apphed for a position in the NRC. Please rate the applicant against the DATE ltems below in respect to the period of bme you either supervtsed or were acquainted with the applicant.

Include any comments you may feel are relevant Please retum the completed form to the Human Resources Staffing Specialist listed in the *FROM" block by the retum date indicated, sealed in the "" " " " *#

enclosed envelope and marked For Addressee Only.

NAME OF APPLICANT TO:

] FwilvN FOR WHICH APPLIED FROM:

HUMAN RESOURCES STAFFING SPECIAL13T i OFFICE OF HUMAN RESOURCES i i U.S. NUCLEAR REGULATORY COfMISSION

__J WASHINGTON DC 205550001 This form is used for investigabng the qualifications of extemal candidates for appointment. The candidate should g$ $ $ $

net be rated on those items which have been hned out by the Human Resources Staffing Specialist as not $ 0$ $ 3:$ $

9 applicable. Additional comments can be provided on the reverse side.

1. QUALITY OF WORK.

2. AMOUNT OF WORK PRODUCED.

3. TYPING.

4. SHORTHAND. -

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 DEADLINES.

9. OFFICE SKILLS (Filing. photocopying, answenng telephones. etc.). I

10. ABILITY TO ESTABLISH EFFECTIVE WORK RELATIONSHIPS WITH:

a. CO-WORKERS.

b. HIGHER LEVEL OFFICIALS.

c. REPRESENTATIVES OF INDUSTRY OR OTHER GOVERNMENT AGENCIES.

11. ORAL EXPRESSION.

12. WRITTEN EXPRESSION.

13. ADAPTABILITY.

14. DEPENDABILITY / RELIABILITY.

15. INITIATIVE.

16. CREATIVITY.

17. ABILITY TO WORK EFFECTIVELY IN STRESSFUL SITUATIONS.

18. WORK HABITS.

19. HOW WOULD YOU RATE APPUCANT IN REGARD TO POTENTIAL FOR FILUNO POSmON FOR WHICH APPLIED 7 20 HAVE YOU ANY REASON TO QUESTION THis PERSON'S TRUSTWORTHINESS OR LOYAL.TY TO THE UNrTED STATES OF AMERr.A 9 YEs (Empialn) NO

21. DO YOU KNOW OF ANY PERSONAL HABITS AND/OR CHARACTERISTICS THAT WOULD MAKE THIS PERSON UNSUITABLE FOR EMPLOYMENT BY THE U.S. GOVERNMEN7 8 **) "U l 22. WOULD YOU REHIRE THiS CANDIDATE 7 (t/ app # cable, circle one) NO N/A (YES]

23. RELATIONSHIP TO APPLICANT I l SUPERVISOR l lCO-WORKER } l PROFESSIONAL I IOTHER (Specffy) l ADDITIONAL COMMENTS (Conbaue on reverse) l l

NOTE: Cormstent with the Prtvecy Act of 19M. this evnlaation may be revealed to the applicant upon his or her request. However,if you request, your identity arai other identifying information wHI be kept confiderdial. Please indicato boku whether you dessre your identity be kept confidential.

MY IDENTITY MAY BE REVEALED. ] I REOUEST MY IDENTITY BE KEPT CONFIDENTIAL.

SIGNATURE I DATE l

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NRC FORM 212A (MM YYYY) PRiffrED ON RECYCLED PAPER The form was des'ened usin0 Informs