NRC Form 354, Data Report on Spouse

ICR 200507-3150-002

OMB: 3150-0026

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
33234 Migrated
ICR Details
3150-0026 200507-3150-002
Historical Active 200205-3150-009
NRC
NRC Form 354, Data Report on Spouse
Extension without change of a currently approved collection   No
Regular
Approved without change 08/25/2005
Retrieve Notice of Action (NOA) 07/15/2005
  Inventory as of this Action Requested Previously Approved
08/31/2008 08/31/2008 08/31/2005
60 0 60
12 0 12
0 0 0

Completion of NRC Form 354 is a mandatory requirement for NRC employees, contactors, licensees, applicants, and others who marry after submission of the Personnel Security Forms, or after receiving an access authorization or employment clearne, to permit the NRC to ensure there is no increased risk to the common defense and security.

None
None


No

1
IC Title Form No. Form Name
NRC Form 354, Data Report on Spouse NRC-354

  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 60 60 0 0 0 0
Annual Time Burden (Hours) 12 12 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$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.
07/15/2005


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