Information Collection

Acknowledgement and Agreement to Participate in the Human Reliability Program (HRP)

IC 44890 under ICR 200611-1910-003 · OMB 1910-5122.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1910-5122 can be found here:

Documents and Forms

Document Name Document Type
Form DOE F 470.4 Acknowledgement and Agreement to Participate in the Human Reliability Program (HRP) Form
DOE F 470.4 Acknowledgment and Agreement to Participate in the Human 470-4[1].pdf Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Acknowledgement and Agreement to Participate in the Human Reliability Program (HRP)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 10 CFR 710, 711, and 712 (To search for a specific CFR, visit the Code of Federal Regulations.)

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	DOE F 470.4	Acknowledgment and Agreement to Participate in the Human Reliability Program (HRP)	470-4[1].pdf		Yes	No	Printable Only

Line of Business: Defense and National Security

Subfunction: Operational Defense

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 11,500	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Change Due to Adjustment in Agency Estimate
Annual Number of Responses for this IC	11,500	11,500
Annual IC Time Burden (Hours)	1,150	1,150
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.