ML18204A250

NRC 790 Classification Record for Renewal

ML18204A250
Person / Time
Issue date:	06/19/2018
From:	NRC/OCIO
To:
References
OMB 3150-0052
Download: ML18204A250 (2)

Text

CLASSIFICATION RECORD NRC FORM 790 (MM-YYYY)U.S. NUCLEAR REGULATORY COMMISSION Authorized classifiers MUST COMPLETE THIS FORM for each classification or declassification review performed. Enter only the number of characters required in each space.

APPROVED BY OMB: NO. 3150-0052 EXPIRES: (MM/DD/YYYY)

Estimated burden per response to comply with this mandatory information collection request: 6 minutes. This submittal is required by NRC to report classification or declassification of documents in accordance with Executive Order 13526. Send comments regarding burden estimate to the Information Services Branch (T-2 F43), U.S. Nuclear Regulatory Commission, Washington, DC 20555-0001, or by e-mail to Infocollects.Resource@nrc.gov, and to the Desk Officer, Office of Information and Regulatory Affairs, NEOB-10202, (3150-0052), Office of Management and Budget, Washington, DC 20503. If a means used to impose an information collection does not display a currently valid OMB control number, the NRC may not conduct or sponsor, and a person is not required to respond to, the information collection.

NRC FORM 790 (MM-YYYY)

SECTION A - TO BE COMPLETED FOR ALL CLASSIFICATION ACTIONS

1. AUTHORIZED CLASSIFIER'S NAME (Last, First, M.I)

2. AUTHORIZED CLASSIFIER'S N UMBER 3. FORM COMPLETION DATE (MM/DD/YYYY)

4. DOCUMENT TITLE

5. FACILITY/OFFICE SYMBOL

6. DOCUMENT DATE (MM/DD/YYYY)

7. TYPE OF ACTION

8. OVERALL CLASSIFICATION CODE SECTION B - TO BE COMPLETED FOR ORIGINAL CLASSIFICATION ACTIONS

9. REASON FOR CLASSIFICATION (Select all that apply)

(a) military plans, weapons systems, or operations; (b) foreign government information; (c) intelligence activities (including covert action), intelligence sources or methods, or cryptology; (d) foreign relations or foreign activities of the United States, including

confidential sources; (e) scientific, technological, or economic matters relating to the national

security; (f) United States Government programs for safeguarding nuclear materials

or facilities; (g) vulnerabilities or capabilities of systems, installations, infrastructures, projects, plans, or protection services relating to the national security; or (h) the development, production, or use of weapons of mass destruction.

10. DECLASSIFICATION INSTRUCTION 1 DATE IN 10 YEARS OR LESS (Complete Item 11 and Skip Item 12) 2 EVENT IN 10 YEARS OR LESS (Skip Item 11 and Complete Item 12) 3 DATE NOT TO EXCEED 25 YEARS (Complete Item 11 and Skip Item 12) 4 25X EXEMPTION WITH DATE (Complete Item 11 and Skip Item 12) 5 25X EXEMPTION WITH EVENT (Skip Item 11 and Complete Item 12) 6 50X EXEMPTION WITH DATE (Complete Item 11 and Skip Item 12) 7 50X EXEMPTION WITH EVENT (Skip Item 11 and Complete Item 12)

11. DECLASSIFICATION DATE (MM/DD/YYYY)

12. DECLASSIFICATION EVENT SECTION C - TO BE COMPLETED FOR DERIVATIVE CLASSIFICATION ACTIONS

13. AUTHORIZED SOURCE FOR CLASSIFICATION AND SOURCE DATE

14. DECLASSIFICATION INSTRUCTION 1 DATE IN 10 YEARS OR LESS (Complete Item 15 and Skip Item 16) 2 EVENT IN 10 YEARS OR LESS (Skip Item 15 and Complete Item 16) 3 DATE NOT TO EXCEED 25 YEARS (Complete Item 15 and Skip Item 16) 4 25X EXEMPTION WITH DATE (Complete Item 15 and Skip Item 16) 5 25X EXEMPTION WITH EVENT (Skip Item 15 and Complete Item 16) 6 50X EXEMPTION WITH DATE (Complete Item 15 and Skip Item 16) 7 50X EXEMPTION WITH EVENT (Skip Item 15 and Complete Item 16) 8 NO FUTURE ACTION (Skip Item 15 and Item 16)

15. DECLASSIFICATION DATE (MM/DD/YYYY)

16. DECLASSIFICATION EVENT SECTION D - TO BE COMPLETED FOR DECLASSIFICATION ACTIONS

17. REASON FOR DECLASSIFICATION REVIEW

1. MANDATORY REVIEW

2. SYSTEMATIC REVIEW

3. CHALLENGE REQUEST

4. FOIA REQUEST

5. FOIA APPEAL

6. AUTOMATIC DECLASSIFICATION

18. NUMBER OF PAGES DECLASSIFIED Page 1 of 1 INSTRUCTIONS FOR COMPLETING NRC FORM 790 PLEASE COMPLETE THIS FORM ELECTRONICALLY, WHEN POSSIBLE. SAVE THE PDF FILE TO YOUR COMPUTER. CLICK THE SUBMIT BY EMAIL BUTTON BELOW.

FORM WILL BE ELECTRONICALLY SUBMITTED TO THE INFORMATION SECURITY BRANCH RECORD CLASSIFICATION ACTION RESOURCE MAILBOX.

CAUTION: In order to complete and/or submit this form electronically, the contents of the form must be UNCLASSIFIED in their entirety. Please verify that the document

title and authorized sources for classification are UNCLASSIFIED in advance of completing this form.

SECTION A - TO BE COMPLETED FOR ALL CLASSIFICATION ACTIONS Section A must be completed for all classification actions, to include original classification, derivative classification, and declassification actions.

Item 1 Type or print the full name of the authorized classified in the order of last name, first name, and middle initial (if applicable).

Item 2 Insert the official four-digit authorized classifier's number issued by the NRC.

Item 3 Insert the date that you completed the NRC Form 790 in the format MM/DD/YY.

Item 4 Insert the unclassified document title.

Item 5 Insert the abbreviation of the authorized classifier's facility or NRC office, as appropriate.

Item 6 Insert the date the document was originated or signed in the format MM/DD/YY.

Item 7 Indicate whether this record reflects an original classification, derivative classification, or declassification action. Original classification is an initial determination that information requires, in the interest of the national security, protection against unauthorized disclosure. Derivative classification is the incorporating, paraphrasing, restating, or generating in new form information that is already classified, and marking the newly developed material consistent with the classification markings that apply to the source information. Declassification is the authorized change in the status of information from classified information to unclassified information.

Item 8 Indicate the overall classification level (Top Secret (TS), Secret (S), or Confidential (C)) and category (Restricted Data (RD) or National Security Information (NSI)) of the document in its entirety or indicate if the document is Unclassified in its entirety.

SECTION B - TO BE COMPLETED FOR ORIGINAL CLASSIFICATION ACTIONS Item 9 If the document includes National Security Information (NSI), then select all applicable reasons for classification in accordance with Executive Order 13526, "Classified National Security Information," Section 1.4, "Classification Categories." If the document is Unclassified in its entirely or only contains Restricted Data (RD), then leave Item 9 blank.Item 10 Indicate the declassification instruction associated with the original classification action. Select "Date in 10 Years or Less" if the declassification date is 10 year or less from the date of original classification. Select "Event in 10 Years or Less" if the declassification event is reasonably expected to occur in 10 year or less from the date of original classification. Select "Date Not to Exceed 25 Years" if the declassification date is between 10 and 25 years from the date of original classification. Select "25X Exemption with Date" if the NRC has an approved 25X exemption for the information and the declassification date does not exceed 50 years. Select "25X Exemption with Event" if the NRC has an approved 25X exemption for the information and the declassification event is reasonably expected to occur within 50 years. Select "50X Exemption with Date" if the NRC has an approved 50X exemption for the information and the declassification date does not exceed 75 years. Select "50X Exemption with Event" if the NRC has an approved 50X exemption for the information and the declassification event is reasonably expected to occur within 75 years.

Item 11 Insert the specific date for declassification in the format MM/DD/YY. Item 11 should only be completed if Code 1, 3, 4 or 6 were selected in Item 10. In all other instances, this item should be left blank.

Item 12 Indicate the specific event for declassification. Item 12 should only be completed if Code 2, 5, or 7 was selected in Item 10. In all other instances, this item should be left blank.SECTION C - TO BE COMPLETED FOR DERIVATIVE CLASSIFICATION ACTIONS Item 13 Indicate the unclassified title of the authorized source used for derivative classification and the date of the source in the format MM/DD/YY. Authorizes sources for classification include classification guides, source documents, and original classification decisions. If multiple authorized sources are used for classification, then indicate "Multiple Sources" for Item 13.

Item 14 Indicate the declassification instruction associated with the original classification action. Select "Date in 10 Years or Less" if the declassification date is 10 year or less from the date of original classification. Select "Event in 10 Years or Less" if the declassification event is reasonably expected to occur in 10 year or less from the date of original classification. Select "Date Not to Exceed 25 Years" if the declassification date is between 10 and 25 years from the date of original classification. Select "25X Exemption with Date" if the NRC has an approved 25X exemption for the information and the declassification date does not exceed 50 years. Select "25 Exemption with Event" if the NRC has an approved 25X exemption for the information and the declassification event is reasonably expected to occur within 50 years. Select "50X Exemption with Date" if the NRC has an approved 50X exemption for the information and the declassification date does not exceed 75 years. Select "50X Exemption with Event" if the NRC has an approved 50X exemption for the information and the declassification event is reasonably expected to occur within 75 years. Select "No Future Action" if the document only contains Restricted Data (RD).

Item 15 Insert the specific date for declassification in the format MM/DD/YY. Item 15 should only be completed if Code 1, 3, 4 or 6 were selected in Item 14. In all other instances, this item should be left blank.

Item 16 Indicate the specific event for declassification. Item 16 should only be completed if Code 2, 5, or 7 was selected in Item 10. In all other instances, this item should be left blank.SECTION D - TO BE COMPLETED FOR DECLASSIFICATION ACTIONS Item 17 Indicate the reason for the declassification review. Select "Mandatory Review" if the declassification review occurred in response to a request for declassification that meets the requirements of Executive Order 13526, "Classified National Security Information," Section 3.5, "Mandatory Declassification Review." Select "Systematic Review" if the declassification review was associated with records that have been determined by the Archivist to have permanent historical value in accordance with title 44, United States Code. Select "Challenge Request" if the declassification review occurred in response to a classification challenge in which an authorized holder believed that the classification status was improper. Select "FOIA Request" if the declassification review occurred in response to a Freedom of Information Act request. Select "FOIA Appeal" if the declassification review occurred in response to a Freedom of Information Act appeal. Select "Automatic Declassification" if the declassification of information was based solely upon the occurrence of a specific date or event as determined by the original classification authority; or the expiration of a maximum time frame for duration of classification established under Executive Order 13526, "Classified National Security Information."

Item 18 Indicate the number of pages declassified