ML22192A197

NRC Form 446 - Request for Approval of Official Foreign Travel by Non-Government Personnel (*Must Be Completed 30 Days Prior to Travel)

ML22192A197
Person / Time
Issue date:	07/11/2022
From:	NRC/OCIO/GEMSD/IMSB
To:
References
Download: ML22192A197 (3)

Text

NRC FORM 446 (07-11-2022)

U.S. NUCLEAR REGULATORY COMMISSION REQUEST FOR APPROVAL OF OFFICIAL FOREIGN TRAVEL BY NON-GOVERNMENT PERSONNEL

(*Must be completed 30 Days Prior to Travel)

NRC FORM 446 (07-11-2022)

NRC MD 14.1 EXPIRES: 06/30/2024 APPROVED BY OMB: NO. 3150-0248 Page 1 of 3 Estimated burden per response to comply with this voluntary collection request: 2 hours2.314815e-5 days <br />5.555556e-4 hours <br />3.306878e-6 weeks <br />7.61e-7 months <br />. NRC uses this form to authorize foreign travel for non-Federal personnel in the course of conducting business for the NRC. 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, (3150-0248), 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.

A. TRAVELER INFORMATION (To be completed by traveler)

Name of Traveler Name of Employer Country of Travel Departure Date (MM/DD/YYYY)

Return Date (MM/DD/YYYY)

Signature of Traveler Purpose of Travel (Please provide a brief description of the purpose for your travel. Please spell out all acronyms.)

List of Persons with whom travel has been coordinated NAME (i.e., Contracting Officer's Representative, OIP Desk Officer, and other travelers)

AGENCY/OFFICE B. REVIEW AND APPROVAL Signature of Contracting Officer's Representative Signature of Deputy Director of Office of International Programs Signature Date (MM/DD/YYYY)

Signature Date (MM/DD/YYYY)

Signature Date (MM/DD/YYYY)

Name of Contracting Officer's Representative (COR)

Deputy Director of Office of International Programs SIGN SIGN SIGN

NRC FORM 446 (07-11-2022)

REQUEST FOR APPROVAL OF OFFICIAL FOREIGN TRAVEL BY NON-GOVERNMENT PERSONNEL (Continued)

(*Must be completed 30 days prior to travel)

NRC FORM 446 (07-11-2022)

U.S. NUCLEAR REGULATORY COMMISSION Page 2 of 3 C. TRAVEL ITINERARY Dates Location (City, Country)

Contact on Site (Name, telephone number, and e-mail address)

Activity

Page 3 of 3 NRC FORM 446 (07-11-2022)

REQUEST FOR APPROVAL OF OFFICIAL FOREIGN TRAVEL BY NON-GOVERNMENT PERSONNEL (Continued)

(*Must be completed 30 days prior to travel)

NRC FORM 446 (07-11-2022)

U.S. NUCLEAR REGULATORY COMMISSION PRIVACY ACT STATEMENT NRC FORM 446 REQUEST FOR APPROVAL OF OFFICIAL FOREIGN TRAVEL BY NON-GOVERNMENT PERSONNEL 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 U.S. Nuclear Regulatory Commission (NRC) on NRC Form 446. This information is maintained in a system of records designated as GSA/GOVT-4 Contracted Travel Services Program described at 74 Federal Register 26700 (June 3, 2009).

1. AUTHORITY: 31 U.S.C. 3511, 3512, and 3523; 5 U.S.C. Chapter 57; and implementing Federal Travel Regulations (41 CFR Chapters 300-304).

2. PRINCIPAL PURPOSE(S): To secure the required NRC approval for official foreign travel.

3. ROUTINE USE(S): In addition to the disclosures permitted under subsection (b) of the Privacy Act, the NRC may disclose information from this system of records:

a.

To another Federal agency, Travel Management Center (TMC), online booking engine suppliers and the airlines that are required to support the DHS/

TSA Secure Flight program. In this program, DHS/TSA assumes the function of conducting pre-flight comparisons of airline passenger information to Federal Government watch lists. In order to supply the appropriate information, these mentioned parties are responsible for obtaining new data fields consisting of personal information for date of birth, gender, redress number, and known traveler number. At this time, the redress number is optional and the known traveler number is for future programs. They may be required to be stored in another phase of the Secure Flight program.

b.

To a Federal, State, local, or foreign agency responsible for investigating, prosecuting, enforcing, or carrying out a statute, rule, regulation, or order, where agencies become aware of a violation or potential violation of civil or criminal law or regulation.

c.

To another Federal agency or a court when the Federal Government is party to a judicial proceeding.

d.

To a Member of Congress or staff on behalf and at the requests of the individual who is the subject of the record.

e.

To a Federal agency employee, expert, consultant, or contractor in performing a Federal duty for purposes of authorizing, arranging, and/or claiming reimbursement for official travel, including, but not limited to, traveler profile information.

f.

To a credit card company for billing purposes, including collection of past due amounts.

g.

To an expert, consultant, or contractor in the performance of a Federal duty to which the information is relevant.

h.

To a Federal agency by the contractor in the form of itemized statements or invoices, and reports of all transactions, including refunds and adjustments to enable audits of charges to the Federal Government.

i.

To a Federal agency in connection with the hiring or retention of an employee; the issuance of a security clearance; the reporting of an investigation; the letting of a contract; or the issuance of a grant, license, or other benefit to the extent that the information is relevant and necessary to a decision.

j.

To an authorized appeal or grievance examiner, formal complaints examiner, equal employment opportunity investigator, arbitrator, or other duly authorized official engaged in investigation or settlement of aggrievance, complaint, or appeal filed by an employee to whom the information pertains.

k.

To the Office of Personnel Management (OPM), the Office of Management and Budget (OMB), or the Government Accountability Office (GAO) when the information is required for program evaluation purposes.

l.

To officials of labor organizations recognized under 5 U.S.C. chapter 71 when relevant and necessary to their duties of exclusive representation concerning personnel policies, practices, and matters affecting working conditions.

m.

To a travel services provider for billing and refund purposes.

n.

To a carrier or an insurer for settlement of an employee claim for loss of or damage to personal property incident to service under 31 U.S.C. 3721, or to a party involved in a tort claim against the Federal Government resulting from an accident involving a traveler.

o.

To a credit reporting agency or credit bureau, as allowed and authorized by law, for the purpose of adding to a credit history file when it has been determined that an individual's account with a creditor with input to the system is delinquent.

p.

Summary or statistical data from the system with no reference to an identifiable individual may be released publicly.

q.

To the National Archives and Records Administration (NARA) for records management purposes.

r. To appropriate agencies, entities, and persons when (1) The Agency suspects or has confirmed that the security or confidentiality of information in the system of records has been compromised; (2) the Agency has determined that as a result of the suspected or confirmed compromise there is a risk of harm to economic or property interests, identity theft or fraud, or harm to the security or integrity of this system or other systems or programs (whether maintained by GSA or another agency or entity) that rely upon the compromised information; and (3) the disclosure made to such agencies, entities, and persons is reasonably necessary to assist in connection with GSA's efforts to respond to the suspected or confirmed compromise and prevent, minimize, or remedy such harm. For additional details on these routine uses, please see the GSA/GOVT-4 system notice.

4. WHETHER DISCLOSURE IS MANDATORY OR VOLUNTARY AND EFFECT ON INDIVIDUAL OF NOT PROVIDING INFORMATION: Disclosure is voluntary; however, if the requested information is not provided, approval for foreign travel may be denied.

5. SYSTEM MANAGER AND ADDRESS: Chief, International Operations Branch, Office of International Programs, U.S. Nuclear Regulatory Commission, Washington, DC 20555-0001.