ML21266A296

OMB 3150-0188, NRC Form 531, Request for Taxpayer Identification Number

ML21266A296
Person / Time
Issue date:	10/01/2021
From:	NRC/OCIO
To:
References
OMB 3150-0188
Download: ML21266A296 (2)

Text

NRC FORM 531 (MM-YYYY)

REQUEST FOR TAXPAYER IDENTIFICATION NUMBER U.S. NUCLEAR REGULATORY COMMISSION NRC MD 12.3 APPROVED BY OMB: NO. 3150-0188 EXPIRES: (MM/DD/YYYY)

Estimated burden per response to comply with this mandatory collection request: 15 minutes. The information is required by NRC to process payments to contractors. Send comments regarding burden estimate to the FOIA, Library, and Information Collections Branch (T-6 A10M), U.S. Nuclear Regulatory Commission, Washington, DC 20555-0001, or by e-mail to Infocollects.Resource@nrc.gov, and the OMB reviewer at: OMB Office of Information and Regulatory Affairs, (3150-0188), Attn: Desk Officer for the Nuclear Regulatory Commission, 725 17th Street NW, Washington, DC 20503; e-mail:

oira_submission@omb.eop.gov. The NRC may not conduct or sponsor, and a person is not required to respond to, a collection of information unless the document requesting or requiring the collection displays a currently valid OMB control number.

In accordance with the Debt Collection Improvement Act of 1996, you are required to provide your taxpayer identification number. This number may be used to make payments (refunds) or for purposes of collecting and reporting on any delinquent amounts arising out of your relationship with the Federal Government.

Please complete the applicable blocks and fax the completed form to (301) 415-6725. Thank you for your assistance and cooperation. If you have any questions, please contact us. Our telephone number is (301) 415-7554.

Indicate the status of your business:

CORPORATION PARTNERSHIP CITY/STATE GOVERNMENT FEDERAL GOVERNMENT INDIVIDUAL OTHER (Specify in box below)

TAXPAYER IDENTIFICATION NUMBER NRC LICENSE OR REGISTRATION NUMBER(S)

OR SOCIAL SECURITY NUMBER EMPLOYER IDENTIFICATION NUMBER Under penalties of perjury, I certify that the number shown on this form is my correct taxpayer identification number.

SIGNATURE - TAXPAYER REPRESENTATIVE NRC LICENSEE OR VENDOR BILLING ADDRESS BILLING TELEPHONE NUMBER BILLING EMAIL ADDRESS NRC Form 531 (MM-YYYY)

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PRIVACY ACT STATEMENT NRC FORM 531 REQUEST FOR TAXPAYER IDENTIFICATION NUMBER 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),

the following statement is furnished to individuals who supply information to the Nuclear Regulatory Commission (NRC) on NRC Form 531. This information is maintained in a system of records designated as NRC-32 and described at 84 Federal Register 71559 (December 27, 2019), or the most recent Federal Register publication of the NRC's Systems of Records Notices that is located in the NRC's Agencywide Documents Access and Management System (ADAMS).

1. AUTHORITY: U.S.C. 552a; 5 U.S.C. 5514; 15 U.S.C. 1681; 26 U.S.C. 6103; 31 U.S.C. chapter 37; 31 U.S.C.

6501 -6508; 42 U.S.C. 2201; 42 U.S.C. 5841; 31 CFR 900 -904; 10 CFR parts 15, 16, 170, 171; Executive Order (E.O.) 9397, as amended by E.O. 13478; and E.O. 12731.

2. PRINCIPLE PURPOSE(S): To obtain taxpayer identification number/social security number/individual taxpayer identification number to enable the NRC to process payments and collect/report delinquent debts.

3. ROUTINE USES: Information from this form may be transmitted to: debt collection contractors and/or Federal agencies for collecting delinquent debts and/or collection action on such debts; any Federal, State or local agencies to conduct authorized computer matching programs and to credit reporting agencies; Treasury on past due nontax debts for the purpose of locating the debtor and/or effecting offset under Treasury Offset Program.

Information may be publicly disseminated regarding the identity of delinquent nontax debtors and the existence of nontax debts under the provisions of the Debt Collection Improvement Act of 1996. Information may be disclosed in accordance with any of the Routine Uses listed in the Prefatory Statement of General Routine Uses, including to an appropriate Federal, State, local or Foreign agency in the event the information indicates a violation or potential violation of law; in the course of an administrative or judicial proceeding; to an appropriate Federal, State, local and foreign agency to the extent relevant and necessary for an NRC decision about you or to the extent relevant and necessary for that agency's decision about you; in the course of discovery under a protective order issued by a court of competent jurisdiction, and in presenting evidence; to a Congressional office to respond to their inquiry made at your request; to NRC-paid experts, consultants, and others under contract with the NRC, on a need-to-know basis; or to appropriate persons and entities for purposes of response and remedial efforts in the event of a suspected or confirmed breach of data from this system of records.

4. WHETHER DISCLOSURE IS MANDATORY OR VOLUNTARY AND EFFECT ON INDIVIDUAL OF NOT PROVIDING INFORMATION: It is mandatory that you furnish the requested information pursuant to the Debt Collection Improvement Act of 1996 (Public Law 104-134). If you do not provide the requested information, we may no longer be able to conduct business with you, and if you are due a refund, you may give up your rights to your refund.

5. SYSTEM MANAGER AND ADDRESS: Comptroller, Division of the Comptroller, Office of the Chief Financial Officer, U.S. Nuclear Regulatory Commission, Washington, DC 20555-001.

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