ML20125C110

Request for OMB Review & Supporting Statement Re NRC Form 354, Data Rept on Spouse. Estimated Respondent Burden Is 22 H

ML20125C110
Person / Time
Issue date:	12/01/1992
From:	Cranford G NRC OFFICE OF INFORMATION RESOURCES MANAGEMENT (IRM)
To:
References
OMB-3150-0026, OMB-3150-26, NUDOCS 9212110044
Download: ML20125C110 (11)

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12N u-WteNtHav s,gn tne repata y cewate r- O' :.e of W,agerred anc bucget tew s e a;wova: unces ne Paperwor. Reductior. Act and 5 C; E 6" D;cret oorary, Roc n 3^^ '

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1. vermet:uem we seeas e e cccmvem 2. Ay nace U.S. Nuclear Regulator; Commission 3 1. 5 O_

De e cc e.su no un een rswer cet ons regra,ng ems rec-si ie epnane numter Duane Ki ( 30Ll492-4124

4. Title of mformat:cn conect'on or rulemaung NRC Form 354, " Data Report on Spouse" s.rew acw , , sor ,esormavon coneet,on or rse ccae unaec sta es Coce. Paonc La v. ct E>ecutae Ome?)

42 usc2201(o) .o, Executive Orders 10450,10865. and 12356

6. A*tected puv.c (checii a4 that arm) 5 U Fecerat egsncies or ernproyees r- -

, L Ind vicua

s of househoids 3 t ! Farms E L j Nun profit mstitutmns 2 U State r.,r ic:a; gove nments C Bus'r essas o'other fo p ct t 7 C SmaM businesses or orgamrations PART ll.-Complete This Part Only if the Request is for OMB Review Under Executive Order 12291

7. Regulation Ident Aer Namber (RIN)

- _ _ __ _ _ _ , or, None ass,gned U 5 Type of submissson (check one m es:n ca rpry) Type of review requested CI:ssification Stags of development , O Standyc 1 CM 40r 1 C Proposec e'drar* 2 C Pendmg 2 Nonmajor 2 Finat or mterim fica . w:tn pnor proposa! 3 C Emegency 3 C rinai or inter,m frat witnout poor proposs 4 C statut0 y oriudic.a deadan.

9. Cf R section affected CFR

10. Does this regutJtron contain reportmg or recordkeepmg reouirements tnat raquire oMD aporovat under the Paperwork Reductio

• Act anc 5 CFR 1320? . C ves C Nc

11. If a niaior tuie. is there a rega:atory impact acetysis attached? 1 C Yes 2 C Na It"No? did oMB wa1ve the ana:ys:s' 3 C Yes 4 C No Certification for "Regulatory Submissions in submittmg this request for oMB rev,ew. the authertzed regulatory contact and tre proram c*f:c a! ce 'h t .at tre revemenu c' E o L.291 and any appLcase pohey directives have been comphed

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EgNture of prog?am officiat i Detf+

I Signature of autnorged regutatory contact s} 4 12, (OMJ use only) '

Prewoor. ormtmana obscwte gg Staward F em 8MAev 9 83)

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1. PART HL

• 1. pthe Regoest is for Approvelof f CeNeedeSQWggfj!W" Med&f' '

e.vi r Meie Pentwork Recuetloa Act and 5 CFR 1320b -" '

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- I sabsect-oactee noenzunes ens enectar pubnc M 50 eres or *ss "Federa l"empl oyerantworki ngpl a c e ^ s a fety "

NRC Form 354;is completedn by NRC contractors, licensee applicants, and employment applicants 1 "9

who are married to alien? spouses; marry alien spouses aftersubm1551on~0f'the PersonnerSecurity" Questionnaire; or afterQpceiving an access authorization or employment clearance. Respondents character and associations are investigated, reported and determined to ensure access authorized pemnnel 41.1 not endTr-comrL4afsnse -and sMety.

14. Type of mforrnetion conect on (chest onh one) information collections not coortainedin rules 1 @ Regular submtsseon 2 O Emergency submission (ceridicationattached)

Information collections contained kt rules 3 0 Ex>stmg regu6 tion (no change procesed) F3 Final or in;enrn fmai w<tnout poor NPRM 7, Enter date of expected or actual Federat 4 C Nct<e of p'roposed ruiematng(NPRM) A O Reg;ar submission Reg ster pubhcat,on at this stage of rutemaking .

5 C Finat, NPRM was provrously pubbshed a O Emergency submssion(certdecation attac^ea) (mc :n. dar rear):

15. Type of reven requated (check only one) 1 O new coiiection 4 O Reinstatement of . previous;y appre,ed coiiection for.hien approva 2 O nevision of a currentry aooroved coo.ction "*'*

3 Q Extension of the expiration date of a currently accroved conectica 5 Existing coFection in use without an oMB controi number without any cnarte m the substance or m the method of conecton

16. Agency report form number (s)(snclude staMardtoptronal forrn number (s)) 22. Purpose of informatson conection (check as many as apply)

, t O Apecate for oenefna NRC Form 354

2 O Program evaiuation

17. Annual reportmg or disclosure burden i 3 0 ceneraipurposestatistics 1 Number of respondeats . bb 4 2 Regulatoryorcomphance h 2 Nureber of responses per respondent I 5 O Program planningormanagement j 3 Total annual responses (hne I times hne 2) 88 6 C Research 4 4 Hours act resportw .25 7- Audit 3

$ Tota! hours (hne 3 trmes une 41 22

18. Annual recrirdkeepmg burden 23. Frequency of recordkeep6ng or reporting (check ah that apody) 1 Number of recorakeepers

• 1 C Recordkeepmg 2 Annual hours pe- recorcheeper. Reporting 3 Total recorcueep.rg hours (hoe 1 times br;e 21 l 2 3 onoccasion -

4 Recordaeeo% retention penco , years! 3 g yf,,ggy

19. Total annua! burden 4 O Month!y 1 Requested (hoe U $ plus hoe 18-3) .  ! --

22 5 0 quarterty 2 m current OMB m<entory 22 s O secm-annuatiy .

3 Dstierente (! ne 1 tess hne 2] 8 7 0 kmua,uy -

e Explanation of ddference i 8 O Bannuatty 4 Pmg am change _ 9 0 otner(cese :be):

5 Adptment . _

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20. Currect (most recent) OM8 eentros nurnoer or cornrvt nmber 24. Respondents' obugation to comply (check ten strongest ochgatio- the appbes)

3150-0026 i O voiuntary

21. Requested expiration date 2 O Required to obtain ur retain a benefit Three _ years f"om da+e of OMB app pyA 3 0D Mandato v

25. Aw tne resconcents nesma:Jy educetoria' ager'c+s or instdutsom -r .5 Ihe pnmary purnse o! the conection related to Nderal education programs? C Yes O No

26. Ctes the nence use samphng to select rennMents or does the nency acummend or prescnte the use of sampneg er stat:stical anatysis oyr. concerts? . O Yes 3 No l 2 /. Gecu=atory acturity "or the mrormat.on ce;ect ce b CFA kSLW m FR  ; or.Ctner(so=ofy):

- Paoe work fe7t31catioa M shtteg tN redest for oW appma' ~e arcy md P s mot " : c ~ c uhon2ed representative. ced es that the reau.remems of 5 CFR 1311 the b Wy 4ct, $tst%Ca' StadaYs -r JJe1. aid rd 3"f ct'*er aci Je mt? T / Ohc, 'ectae) have Deen compbec with 5 gnature d Drogram OMU j Cate

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~4 OMB SUPPORTING STATEMENT-FOR NRC FORM-354

" DATA REPORT ON SPOUSE" ,

3150-0026 Descriotion of Infor,mation Collection. This reporting requirement-affects approximately 88 individuals annually. The respondents are NRC. contractors, NRC licensee applicants, and-NRC employment applicants who are married to non-U.S. citizens and are applying for NRC access authorization or employment clearance. The form must also be completed by respondents who marry after completing the Perstnnel Security Forms, or after having been granted an NRC access authorization or employment -'

clearance.

A. Justification

1. Need for the Collection of Information. Section 145 of the Atomic Energy-Act (AEA) of 1914, as amended, requires',

before an individual can be granted access to Restricted Data (RD), an investigation and report on the individual's character, associations aa0 ?.oyalty and a determination that permitting such a person access to'RD will not endanger the commen defense and security. ,

The basic security standard of Executive Order 10450, .

- " Security Requirements fcr' Government Employment," for employment, or retention of an individual in a ransitive position, is that such employment or retention zs:" clearly consistent with the interests of the-national security."

Executive Order 10865, " Safeguarding Classified Information Within Industry," likewise permits _the "...headiof a department or his designee..." to grant access p authorizations for industrial employees (NRC 1 contractors)

" " ... only upon finding that it is clearly consistent with the national interest.to do so."

10 CFR Part 10- Subpart B,_" Criteria and Procedures for l Determining Eligibility for Access to Restricted Data or

[ National Security _Information or an. Employment-Clearance,"

provides criteria to assist in making this-determination.

L In order for NRC to implementithis responsibility, it is essential, from a security standpoint, that-NRC receive information in addition to that provided on-the Standard -

Form (SF) 86, " Questionnaire for Sensitive Positions,"

l- concerning (1) non-U.S. citizen spouses of NRC applicants; l (2) non-U.S. citizen spouses of NRC contractor-and licensee 1 employees pending NRC access authorization processing; (3) spouses of NRC applicants, contractor,or licensee-employees.

( who marry after appl /ing for NRC access authorization; and--

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.(4) spouses of NRC contractor and NRC licensee employees who marry after having been granted NRC access authorization.

The SF-86 is ncrmally only'used for initial investigations l

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I . , . .

and five year reinvestigations and does not contain the required' amount of detail for NRC purposes. The NRC Form 354 is submitted only as needed (initial investigation, or five year reinvestigation, or at any other time marriage to a non-U.S.' citizen occurs) and provides more detail for NRC purposes. .Specifically, the NRC Form 354 provides the following additional information concerning the spouse's .

citizenship, military service, and ralatives: 1) whether the individual is a U.S. citizen, an alien or possesses dual citiu nship. If a U.S. citizen, whether a) by birth, b).

derivative (including date, certificate number, and place) or c) by naturalization (including petition number, date, certificate number, and place). If alien, allon registration number, date of entry, port of entry and present citizenship; 2) past or present military service, including country, serial number, branch, and the period of service; and 3) relatives (i.e., parents, divorced spouse (s), children, brothers, sisters, stepbrothers, stepsisters, half brothers, half sisters, living or dead),

to include relation, name in full, date of birth, address, country of birth and oresent citizenship. This level of detail is necessary .o 1) permit the NRC Division of Security (SEC) to determine whether or not any information on the form has an impact on the respondent's initial or continued eligibility for access authorization or einployment clearance; and 2) permit the Federal Bureau of Investigation (FBI) to complete a name check of FBI files. Use of the SF-86 alone would fail to obtain this vital.information. We note that the National Industrial Security Program's_(NISP) l proposed Personnel Security Questionnaire (PSG) will collect necessary information on non-U.S. citizen spouses of l applicants for access authorization or employment clearance.

l At such time as the NISP PSQ is approved, use of the NRC '

l Form 354 will be limited to those individuals who marry subsequent to the completion of the SF-86 or NISP PSQ and ,

l. who are not otherwise due for reinvestigation. The NRC Form 354 is similar to the Department of Energy's (DOE's) Form DOE F 5631.34.(OMB approval 1910-1800). DOE is an agency with similar responsibilities to NRC.

2. Acency Use of Informat19D. The information supplied-identifies the respondent, marriage, and data on the spouce l-and spouse's relatives. This information permits an initial security determination by the_SEC as to whether or not any .

information on the form has an impact on the respondents ,

initial or continued eligibility for access. authorization or -

l employment clearance. A copy of the completed form is sent l to the FBI where a name check of FBI files is completed. In the' case of non-U.S. citizen spouses and relatives, appropriate chocks at other appropriate Government agencies may also be completed. The results of-the completad FBI and

, other agency checks are returned to SEC whereupon a second

! evaluation / determination is made, based'on any developed l Information, as to whether it has any impact on the

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b respondent's initial or continued eligibility for access authorization or an employment clearance.

3. Egd.uction of Burden Throuch Information Technoloav. Because-the information is required of individuals and not of corporations or businesses, it is not possible to reduce the burden of 15 minutes per respondent through information technology.

4. Effort to Identify Duolication. Some of the elements on the NRC Form 354 are duplicative of those on the SF-86 (i.e.,

name of employee or applicant, other names-used by employee or applicant, . employment, date and place _of .arriage, precent name of spouse, other names used'by spouse, date and' place >f birth of spouse,-present address of spouse). This duplication is necessary because 1) the two forts are generally forwarded to different government agencies: the SF-86 is sent to OPM for the conduct of a background investigation whereas the NRC Form 354 goes to the FBI for a name check on the spouse; 2) a copy of the'SF-86 to the FBI is not practicable because it fails to provide the necessary level of detail on the spouse; and 3) the NRC Form 354 is frequently completed independently of-the SF-86 (i.e., when an individual marries subsequent to an initial investigation or five year reinvestigation). Note that reference to NRC Form 1 is marked out on the enclosed copy of the NRC Form-354. The NRC Porm 1 Mas discontinued because it was duplicative of information collected on the revised SF 86.

5. Effort to Use Si.tilar Information. No.similar information exists. As with other personal information-required from an

! individual applying for or processing an 1U00 access

authorization, this too must be supplied by the individual.

No alternative sources are available.

6. Effort to Rednge_Smal.1 Business Burden. The licensees I affected by this information collection are not small-entities or businesses as those terms are used in-the Regulatory Flexibi_lity Act.

7. Consecuences of Le.ss Frecuent Collection.

There is no established reuorting frequency or period for submittal of NRC Form 354. This form is submitted only when an applicant marries after conpleting Fersonnel Security Forms;. marries L after receiving an access authorizaticn;-or an applicant L -married to a non-U.S. citizen requests an NRC access L authorization.

8. Circumstances Which Justify V.ariation-from OMB Guidelines.

There is no variation from OMB Guidelines in this collection of information. Two copies of NRC Form 354 must be submitted to the SEC. The original copy is forwarded to the-FBl. The second copy is retained in the NRC personnel

(- security file'until-the original is' returned.to NRC. The-I I. N

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.. w second copy is then destrcyed.

9. Consultations Outside-the NR'J. No consultations.

10. Confidentiality of the Information. The information is used for determining initial and continuing eligibility for access authorization. The information is protected from public disclosure under the Privacy Act of 1974 and is handled in accordance with routine uses specified in the Privacy Act Statement conthinet on the form.

11. Justification for Swasitive Ouestions. The NRC Form 354 requests information regarding the applicant's or employee's marriage and identifying informatior regarding his/her spouse and spouse's relatives. This information'is essential for identification purposes and to permit NRC-to make its determination regarding eligibility for access authorization in accordance with appropriate statutes, executive orders and regulations.

12. Estimated Annualized Cost to the Federal GovernM9Bt. The annual cost to NRC of receiving and processing the form is estimated at $2,706 (88 reports x .25/hr x $123).

13. Estimate of Burden. An estimated 15 minutes is required of each of the 88 respondents to complete each NRC~ Form 354, resulting in a total annual burden to'the public of 22 hours2.546296e-4 days <br />0.00611 hours <br />3.637566e-5 weeks <br />8.371e-6 months <br />. The burden estimates are derived from a review of the present esage of the form by contractors, licensees, and NRC employment applicants. Therefore, based on this review and a 'r iew of the amount of time it takes the affected indiv ' .als to complete the form, it is-our belief that these estimates are considered reasonable.

14. Reason for Chances in Burden. There has been no change in the burden on the public associated with the completion of NRC Form 354, since the current OMB approval.

15. Publication for Statistical Use. None.

B. Collections of Information Emplovino Statistical Methods l

This collection of information does not employ statistical methods.

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Nac 'ORM 3e4 U.S. NUCLE AR Mt0ULAVORY COheM158 TON APPmovtD OMe: NO. 316040?e pool supines. eemse fattMaTED SUADEN PER RE$PONSE TO CUMPLY wtTM TMis INFORMATION COLLECTION mfQut:T: JS Hmt Pom.

DATA REPORT ON SPOUSE WAao COMMENT: aso^aoWo suaoeN istiMATs To tae IN70AMAf TON AND REconDS MANAGEMENT oRANCM WNee 1714), U.S. NUCLE AR REGLLATORY COMusss@N.

WASHiNOTON. DC 20566, AND TO THE PAPERWORK REDUC.

TION PROJsCT (31so40261 OPHCE 07 MANAGtWENT AND SUDGtT. W ASHINGTGN. Dd 206L 4.

INSTRUCTIONS . This form shall be completed by any applicant who: (a) marries after :ompleting snarer 4ewne C; N,.., ;,

poemannstesserwy OUsicennewe,.i.ar SF 88," Questionnaire for Sensitive Positions);(b) marries efter having been g ented an eccen authorization or employment cientence;ar (c) is married to a non-U.S. citizen and requests NRC accou outhorization or employment ctkerence,

1. N AME OF EM%OYEE OR APPLICANT ILast, First, Middie) 2,OTHER NAMES USED BY EMPLOYEE OR APPLICANT (Maiden name and/or other names previously used)

3. EMPLOY ~AENT (Present assipm"rt) 4. CATE AND PLACE OF MARRIAOE 6, PRESENT N AME OF SPOUSE (Last, First, Middle) 6.9THER NAMES USED BY ff0JS~ (Maiden nama endier all other names previously used) 7.DATE AND PLACE OF BIRTH OF SPOUSE 8. PRE 3'...r EMPLOYMENT OF SPOUSE (Nemo and location) ve LAST PAEVIOUS EMPLOYMENT

9. PRESENT ADDRESS OF SPOUSE 10. LAST PREVIOUS ACORESS OF SPOL'SE

11. CITIZENSHIP OF SPOUSE: U.S _

DUAL U (if dual, specify countries)

ALIEN IF U.S. CITIZEN, INDICATE WHETHER: IF ALIEN, INDICATE ALIEN REOISTRATION NO.

(A) BY DIRTH (C) BY N ATURALIZATION l (B) DERIVATIVE PETITION NO. (A) DATE OF ENTRY (C) PRESENT CITIZENSHIP OATE DATE CERTIFICATE NO. CERTIFICATE NO. (B) PCAT OF ENTRY PLACE PLACE

12. MILITARY SERVICE OF SPOUSE (f est 7[present i COUNTRY BRANCH SERI.e. 10 rROM (YR.) TO (YR.)

13. SPOUSE'S RELATIVES (Parents, divorce (f soouse or spouses. children, brothers. s,sters, steobrothers, steOI;sters, half brothers, half sisters, living or dearil R E LATION NAME IN FULL OAT ADDR ESS COU Y Of P E NT g

I

14. SIGN ATURE OFYt2LOYEE OR APPLICANT DATE NRC FILE NO. (To be filled in by Security Office)

NMc FQAM JS4 44 909 4

- . ._ . ~

m ,. 4 PLIVACY ACT STATEMENT Pursuant to 5 U.S.C. 551a (e) (3) , enacted ir.to law by section 3 of the Privacy Act of 1974 (Public Law 93-f M > . the following statement is furnished to individuals who suppmy inf m ation to the Nuclear Regulatory Commission (NRC) on NRC Pr.< m 354. This information is maintained in a system of records designated as NRC-39 and described at 51 Federal Recister 33168 (September 18, 1986), and revised at 52 Federal Reaister 4427 (February 11, 1987).

1. AVALQB1IX. Sections 145 and 161(i) of the Atomic Energy Act of 1954, as amended (42 U.S.C. 2165 and 2201(1); Executive Orders 10450, 108 65, and 12 3 56 ; 4 0 U.S. C. , 318; OMB Circular No. A-130; Federal Personel Manual 732 and authorities cited therein.

2. PRINCIPAL PURPOSE (S) . Information entered on this form is used as a basis for an investigation to determine your initial or continuing eligibility for NRC employment, access to Restricted Data, National Security Information, or special nuclear material; or for access to NRC buildings or access to Federal automated information systems or data.

3. ROUTING UBES. This information may be disclosed to %deral investigative agencies for the purpose of conducting a i.ecurity lavestigation for the NRC. The information may an,o be Giaclosed to an appropriate Federal, State or local agency in ttn event the information idicates a violation or patential vic -ac. ton of law and in the course of an administrative or judical proceeding.

In addition, this information may be transferred to an appropriate Federal, State, ano local agency to the extent relevant and necessary for an NRC decision or to an appropriate Federal agency to the extent relevant and necessary for that agency's decision about you.

4.

WHETHER DISCLOSURE IS MANDATORY OR VOLUNTARY AND EFFECTIVE ON INDIVIDUAL.0F NOT PROVIDING INFORMATIOl{. Disclosure of this information is voluntary; however, if it is not supplied, your clearance processing may be dela ad or your application may not be processed.

5. SYSTJM MANAGER AND ADDRESS. Director, Division of Security, Office of Administration, U.S. Nuclear Regulatory Commission, Washington, Dd 20555.

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• 4 NUCLEAR REGULATORY COMMISSION Documents Containing Reporting or Recordkeeping Requirements: Office of Management and Budget (OMB) Review AGENCY : Nuclear Regulatory Commission (NRC)

ACTION: Notice of the OMB review of information collection

SUMMARY

The NRC has recently submitted to OMB for review the following propocal for the collection of information -

under the provisions of the Paperwork Reduction Act of 1980 (44 U.S.C. Chapter 35).

1. Type of submission, new, revision, or extension:

Extension

2. The title of the information collection:' Data Report on Spouse

3. The form number if 6pplicable: NRC' Form 354

4. How otten the collection is required: .On occasion l

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5. Who will be required or asked to report: NRC employees, NRC contractors, and NRC licensee access authorization applicants who are married to non-U.S. citizens; marry after completing NRC's Personnel Security Forms; or marry after having been g" anted an 1;RO access authorization or employment clearance.

6. An estimate of the number of responses annually:

88

7. An estimate of the number of hours needed annually to complete the requirement or request: 22 (.25 hours2.893519e-4 days <br />0.00694 hours <br />4.133598e-5 weeks <br />9.5125e-6 months <br /> per response)

8. An indication of whether Section 3504 (h), Pub. L.96-511 applies: Not applicable

9. Abstract: The NRC Form 354 is completed by NRC contractors, licensee applicants, and employee applicants who are married to non-U.S. citizens; marry after submission of the Personnel Security For's, or after receiving an access authorization j or euployment clearance.

Copies of the submittal aay be inspected or obtainod for a fee from the NRC Pu'elic Document Room, 2120 L Street N.W. (Lower 1

Level), Washington, DC. Comments and questions can be directed -

by mail to the OMB reviewer:

nonald Minsk

. Office of Information and Regulatory Affairs (3150-0026)

NEOB-3019 Office of Management and Budget Washington, D.C. 20503 Comments can also be submitted by telephone at (202) 395-3084.

The NRC Clearance Officer is Brenda Jo. Shelton, (301) 492-8132.'

Date.d at Bethesda, Maryland this / day of / 4 ,1992.

or the Nuclear R gulatory Commission

? -

erald F. branford, D ignated Senior.

Official for Information Resources Management