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| {{#Wiki_filter:NRC FORM 974 U.S. NUCLEAR REGULATORY COMMISSION APPROVED BY OMB: NO. 3150-XXXX EXPIRES: (MM/DD/YYYY) | | {{#Wiki_filter:NRC FORM 974 U.S. NUCLEAR REGULATORY COMMISSION APPROVED BY OMB: NO. 3150-XXXX EXPIRES: (MM/DD/YYYY) |
| (MM-DD-YYYY) Estimated burden per response to comply with this voluntary information collection request: 15 minutes. This information is required by the National Institute of Science and Technology (NIST) Special Publication 800-53 Revision 5, Security and Privacy Controls for Information Systems and Organizations. The Nuclear Regulatory Commission (NRC) is providing an electronic mechanism for the public to voluntarily register complaints, concerns or questions regarding data collection PRIVACY ACT COMPLAINTS, practices at 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 email to CONCERNS OR QUESTIONS FORM Infocollects.Resource@nrc.gov, and the OMB reviewer at: OMB Office of Information and Regulatory Affairs, (3150-XXXX), Attn: Desk Officer for the Nuclear Regulatory Commission, 725 17th Street NW, Washington, DC 20503; email: | | (MM-DD-YYYY) Estimated burden per response to comply with this voluntary information collection request: 15 minutes. This information is required by the National Institute of Science and Technology (NIST) Special Publication 800-53 Revision 5, Security and Privacy Controls for Information Systems and Organizations. The Nuclear Regulatory Commission (NRC) is providing an electronic mechanism for the public to voluntarily register complaints, concerns or questions regarding data collection PRIVACY ACT COMPLAINTS, practices at 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 email to CONCERNS OR QUESTIONS FORM Infocollects.Resource@nrc.gov, and the OMB reviewer at: OMB Office of Information and Regulatory Affairs, (3150-XXXX), Attn: Desk Officer for the Nuclear Regulatory Commission, 725 17th Street NW, Washington, DC 20503; email: |
| 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. | | 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. |
| Name (Last, First, and Middle Initial) Telephone Number Email Address Provide summary of complaint or a written description of the specific circumstances. | | Name (Last, First, and Middle Initial) Telephone Number |
| | |
| | Email Address |
| | |
| | Provide summary of complaint or a written description of the specific circumstances. |
| | |
| Provide a summary of the actions you or the NRC has taken to resolve this complaint. | | Provide a summary of the actions you or the NRC has taken to resolve this complaint. |
| | |
| Provide the preferred method of contact regarding your complaint (i.e., mailing address, email address, phone number) | | Provide the preferred method of contact regarding your complaint (i.e., mailing address, email address, phone number) |
| | |
| Note: NRC will send acknowledgement within 10 business days of receipt of your complaint. | | Note: NRC will send acknowledgement within 10 business days of receipt of your complaint. |
| Signature and Date NRC Form 974 (MM-DD-YYYY) Submit by Email}} | | |
| | Signature and Date |
| | |
| | NRC Form 974 (MM-DD-YYYY)}} |
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Category:Administrative Form
MONTHYEARML23254A2252024-06-0404 June 2024 OMB 3150-XXXX New NRC Form 995, Authorization for Use or Disclosure of Protected Health Information ML23319A4462023-11-15015 November 2023 NRC 749 Form (OMB Copy)(07-06-2023) Fm ML23227A1742023-10-0202 October 2023 NRC Form 354, Data Report on Spouse ML23227A0392023-08-15015 August 2023 Form 366 OMB Screen Shots (MAP-X) ML23089A2902023-06-28028 June 2023 NRC Form 974 Privacy Act Complaints Form ML23017A1342023-02-22022 February 2023 NRC 629 (OMB Copy) - Authorization for Payment by Credit Card ML23047A4082023-02-16016 February 2023 Final Screen Shots for Foreign Travel Reporting ML22306A0632022-11-15015 November 2022 NRC Form 313A (RSO) for OMB Renewal 2022 ML22306A0642022-11-15015 November 2022 NRC Form 313 for OMB Renewal 2022 ML22306A0612022-11-15015 November 2022 NRC Form 313A(ANP) for OMB Renewal 2022 ML22306A0592022-11-15015 November 2022 NRC Form 313A(AUD) for OMB Renewal 2022 ML22306A0602022-11-15015 November 2022 NRC Form 313A(AUS) for OMB Renewal 2022 ML22306A0582022-11-15015 November 2022 NRC Form 313A(AUT) for OMB Renewal 2022 ML22235A6832022-08-23023 August 2022 NRC 237 (OMB Copy) (08-23-2022) Fm ML21356A0032022-08-0303 August 2022 NRC Form 748, National Source Tracking Transaction Report ML22186A2322022-07-0101 July 2022 NRC 748 Long Form (OMB Copy)(07-01-2022) Fm ML22186A2332022-07-0101 July 2022 NRC 748A Report Source (OMB Copy)(07-01-2022) Fm ML22186A2342022-07-0101 July 2022 NRC 748B Transfer Source (OMB Copy)(07-01-2022) Fm ML22186A2352022-07-0101 July 2022 NRC 748C Receive Source (OMB Copy)(07-01-2022) Fm ML22186A2362022-07-0101 July 2022 NRC 748d Dispose Source (OMB Copy)(07-01-2022) Fm ML22186A2372022-07-0101 July 2022 NRC 748e Manufacture Source (OMB Copy)(07-01-2022) Fm ML22186A2382022-07-0101 July 2022 NRC 748F Import Source (OMB Copy)(07-01-2022) Fm ML22186A2392022-07-0101 July 2022 NRC 748G Export Source (OMB Copy)(07-01-2022) Fm ML22186A2402022-07-0101 July 2022 NRC 748H Disassemble Source (OMB Copy)(07-01-2022) Fm ML22123A1072022-05-17017 May 2022 NRC Form 646, Formal Discrimination Complaint (for OMB Submission) ML22123A1522022-05-17017 May 2022 NRC 655, Eeo Counselors Report (OMB Submission Copy) ML21340A0172022-03-0404 March 2022 OMB 3150-0036, NRC Form 830 ML21340A0192022-03-0404 March 2022 OMB 3150-0036, NRC Form 830A (Continuation) ML21340A0202022-03-0404 March 2022 OMB 3150-0036, NRC Form 831 ML21340A1032022-03-0404 March 2022 OMB 3150-0036, NRC from 831A (Continuation) ML20308A4332020-11-0303 November 2020 NRC 782, Complaint Form with Updated Privacy Act Statement ML20224A1672020-10-0606 October 2020 NRC Form 781 (OMB Copy) ML20162A2112020-08-0505 August 2020 OMB 3150-XXXX, (New) NRC Form 149, Ocfo Invitational Traveler Request Form (OMB Copy) ML20066F2032020-05-28028 May 2020 NRC Form 782, Complaint Form ML20126G4692020-05-0505 May 2020 Part 55 Research and Test Reactors Exemption Request 5-4-20 ML20126G4902020-04-29029 April 2020 Part 55 Exemption Request for Power Reactors ML19172A1462019-06-21021 June 2019 NRC 781 (OMB Copy)(06-20-2019) Fm ML19172A1652019-06-21021 June 2019 NRC 782 (OMB Copy)(06-20-2019)FM ML19057A1612019-03-26026 March 2019 NRC Form 361 - Reactor Plant Event Notification Worksheet - (OMB Copy) ML19057A1672019-03-26026 March 2019 NRC 361A (OMB Copy)- Fuel Cycle and Materials Event Notification Worksheet ML19057A1692019-03-26026 March 2019 NRC Form 361N - Non-Power Reactor Event Notification Worksheet - (OMB Copy) ML18269A1402018-12-28028 December 2018 NRC Form 830 - Report of Import ML18269A1412018-12-28028 December 2018 NRC Form 830A - Report of Import Continuation Sheet ML18269A1432018-12-28028 December 2018 NRC Form 831A - Report of Export Continuation Sheet ML18295A5942018-10-22022 October 2018 Draft NRC Form 755, Advance Notification to the NRC of Shipments of Category 1 Quantities of Radioactive Material ML18081A4232018-09-27027 September 2018 Draft NRC Form 361, Reactor Plant Event Notification Worksheet ML18081A4652018-09-27027 September 2018 Draft NRC Form 361A, Fuel Cycle and Materials Event Notification Worksheet ML18081A4912018-09-27027 September 2018 Draft NRC Form 361N, Non-Power Reactor (NPR) Event Notification Worksheet ML18002A4752018-04-20020 April 2018 OMB 3150-0027, NRC Form 7, Application for NRC Export/Import License, Amendment, Renewal, or Consent Request(S) 2024-06-04
[Table view]Some use of "" in your query was not closed by a matching "". Category:NRC
MONTHYEARML23254A2252024-06-0404 June 2024 OMB 3150-XXXX New NRC Form 995, Authorization for Use or Disclosure of Protected Health Information ML23319A4462023-11-15015 November 2023 NRC 749 Form (OMB Copy)(07-06-2023) Fm ML23227A1742023-10-0202 October 2023 NRC Form 354, Data Report on Spouse ML23227A0392023-08-15015 August 2023 Form 366 OMB Screen Shots (MAP-X) ML23089A2902023-06-28028 June 2023 NRC Form 974 Privacy Act Complaints Form ML23017A1342023-02-22022 February 2023 NRC 629 (OMB Copy) - Authorization for Payment by Credit Card ML23047A4082023-02-16016 February 2023 Final Screen Shots for Foreign Travel Reporting ML22306A0632022-11-15015 November 2022 NRC Form 313A (RSO) for OMB Renewal 2022 ML22306A0642022-11-15015 November 2022 NRC Form 313 for OMB Renewal 2022 ML22306A0612022-11-15015 November 2022 NRC Form 313A(ANP) for OMB Renewal 2022 ML22306A0592022-11-15015 November 2022 NRC Form 313A(AUD) for OMB Renewal 2022 ML22306A0602022-11-15015 November 2022 NRC Form 313A(AUS) for OMB Renewal 2022 ML22306A0582022-11-15015 November 2022 NRC Form 313A(AUT) for OMB Renewal 2022 ML22235A6832022-08-23023 August 2022 NRC 237 (OMB Copy) (08-23-2022) Fm ML21356A0032022-08-0303 August 2022 NRC Form 748, National Source Tracking Transaction Report ML22186A2322022-07-0101 July 2022 NRC 748 Long Form (OMB Copy)(07-01-2022) Fm ML22186A2332022-07-0101 July 2022 NRC 748A Report Source (OMB Copy)(07-01-2022) Fm ML22186A2342022-07-0101 July 2022 NRC 748B Transfer Source (OMB Copy)(07-01-2022) Fm ML22186A2352022-07-0101 July 2022 NRC 748C Receive Source (OMB Copy)(07-01-2022) Fm ML22186A2362022-07-0101 July 2022 NRC 748d Dispose Source (OMB Copy)(07-01-2022) Fm ML22186A2372022-07-0101 July 2022 NRC 748e Manufacture Source (OMB Copy)(07-01-2022) Fm ML22186A2382022-07-0101 July 2022 NRC 748F Import Source (OMB Copy)(07-01-2022) Fm ML22186A2392022-07-0101 July 2022 NRC 748G Export Source (OMB Copy)(07-01-2022) Fm ML22186A2402022-07-0101 July 2022 NRC 748H Disassemble Source (OMB Copy)(07-01-2022) Fm ML22123A1072022-05-17017 May 2022 NRC Form 646, Formal Discrimination Complaint (for OMB Submission) ML22123A1522022-05-17017 May 2022 NRC 655, Eeo Counselors Report (OMB Submission Copy) ML21340A0172022-03-0404 March 2022 OMB 3150-0036, NRC Form 830 ML21340A0192022-03-0404 March 2022 OMB 3150-0036, NRC Form 830A (Continuation) ML21340A0202022-03-0404 March 2022 OMB 3150-0036, NRC Form 831 ML21340A1032022-03-0404 March 2022 OMB 3150-0036, NRC from 831A (Continuation) ML20308A4332020-11-0303 November 2020 NRC 782, Complaint Form with Updated Privacy Act Statement ML20224A1672020-10-0606 October 2020 NRC Form 781 (OMB Copy) ML20162A2112020-08-0505 August 2020 OMB 3150-XXXX, (New) NRC Form 149, Ocfo Invitational Traveler Request Form (OMB Copy) ML20066F2032020-05-28028 May 2020 NRC Form 782, Complaint Form ML20126G4692020-05-0505 May 2020 Part 55 Research and Test Reactors Exemption Request 5-4-20 ML20126G4902020-04-29029 April 2020 Part 55 Exemption Request for Power Reactors ML19172A1462019-06-21021 June 2019 NRC 781 (OMB Copy)(06-20-2019) Fm ML19172A1652019-06-21021 June 2019 NRC 782 (OMB Copy)(06-20-2019)FM ML19057A1612019-03-26026 March 2019 NRC Form 361 - Reactor Plant Event Notification Worksheet - (OMB Copy) ML19057A1672019-03-26026 March 2019 NRC 361A (OMB Copy)- Fuel Cycle and Materials Event Notification Worksheet ML19057A1692019-03-26026 March 2019 NRC Form 361N - Non-Power Reactor Event Notification Worksheet - (OMB Copy) ML18269A1402018-12-28028 December 2018 NRC Form 830 - Report of Import ML18269A1412018-12-28028 December 2018 NRC Form 830A - Report of Import Continuation Sheet ML18269A1432018-12-28028 December 2018 NRC Form 831A - Report of Export Continuation Sheet ML18295A5942018-10-22022 October 2018 Draft NRC Form 755, Advance Notification to the NRC of Shipments of Category 1 Quantities of Radioactive Material ML18081A4232018-09-27027 September 2018 Draft NRC Form 361, Reactor Plant Event Notification Worksheet ML18081A4652018-09-27027 September 2018 Draft NRC Form 361A, Fuel Cycle and Materials Event Notification Worksheet ML18081A4912018-09-27027 September 2018 Draft NRC Form 361N, Non-Power Reactor (NPR) Event Notification Worksheet ML18002A4752018-04-20020 April 2018 OMB 3150-0027, NRC Form 7, Application for NRC Export/Import License, Amendment, Renewal, or Consent Request(S) 2024-06-04
[Table view]Some use of "" in your query was not closed by a matching "". |
Text
NRC FORM 974 U.S. NUCLEAR REGULATORY COMMISSION APPROVED BY OMB: NO. 3150-XXXX EXPIRES: (MM/DD/YYYY)
(MM-DD-YYYY) Estimated burden per response to comply with this voluntary information collection request: 15 minutes. This information is required by the National Institute of Science and Technology (NIST) Special Publication 800-53 Revision 5, Security and Privacy Controls for Information Systems and Organizations. The Nuclear Regulatory Commission (NRC) is providing an electronic mechanism for the public to voluntarily register complaints, concerns or questions regarding data collection PRIVACY ACT COMPLAINTS, practices at 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 email to CONCERNS OR QUESTIONS FORM Infocollects.Resource@nrc.gov, and the OMB reviewer at: OMB Office of Information and Regulatory Affairs, (3150-XXXX), Attn: Desk Officer for the Nuclear Regulatory Commission, 725 17th Street NW, Washington, DC 20503; email:
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.
Name (Last, First, and Middle Initial) Telephone Number
Email Address
Provide summary of complaint or a written description of the specific circumstances.
Provide a summary of the actions you or the NRC has taken to resolve this complaint.
Provide the preferred method of contact regarding your complaint (i.e., mailing address, email address, phone number)
Note: NRC will send acknowledgement within 10 business days of receipt of your complaint.
Signature and Date
NRC Form 974 (MM-DD-YYYY)