Security Termination Statement -- NRC Form 136

ICR 199809-3150-001

OMB: 3150-0049

Federal Form Document

Forms and Documents
Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
IC ID
Document
Title
Status
42816 Migrated
ICR Details
3150-0049 199809-3150-001
Historical Active 199805-3150-007
NRC
Security Termination Statement -- NRC Form 136
No material or nonsubstantive change to a currently approved collection   No
Regular
Approved without change 09/17/1998
Retrieve Notice of Action (NOA) 09/17/1998
  Inventory as of this Action Requested Previously Approved
07/31/2001 07/31/2001 07/31/2001
400 0 400
40 0 400
0 0 0

The NRC form 136 affects employees of licensees and contractors who have been granted an NRC access authorization. When the access authorization is no longer needed, the completion of the form apprises the respondent of their continuing security responsibilities and is used to initiate termination of the access authorization.

None
None


No

1
IC Title Form No. Form Name
Security Termination Statement -- NRC Form 136 NRC-136

  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 400 400 0 0 0 0
Annual Time Burden (Hours) 40 400 0 -360 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
Yes

$0
No
No
Uncollected
Uncollected
Uncollected
Uncollected

  No

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
09/17/1998


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