Information Collection

Nuclear Test Personnel Review Forms

IC 181351 under ICR 200802-0704-001 · OMB 0704-0447.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0704-0447 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form DTRA Form 150 Nuclear Test Personnel Review Forms	Form
DTRA Form 150 Nuclear Test Personnel Review Information Request and Re DTRA Form 150.pdf	Form
DTRA Form 150-A Questionnaire for Continental United States Test Partici DTRA Form 150-A - Continental Questionnaire.pdf	Form
DTRA Form 150-B Questionnaire for Oceanic Test Participants DTRA Form 150-B - Oceanic Questionnaire.pdf	Form
DTRA Form 150-C Questionnaire for Crossroads Test Participants DTRA Form 150-C - Xroads Questionnaire.pdf	Form
DoD PIA for NTPR - 06 Oct 2006.pdf DoD PIA for NTPR	IC Document
DOD_Radiation_&_Secrecy_Agreements.pdf DoD Radiation and Secrecy Agreements	IC Document

IC Title:

Nuclear Test Personnel Review Forms

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 32 CFR 218

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Electronic Capability
Form	DTRA Form 150	Nuclear Test Personnel Review Information Request and Release	DTRA Form 150.pdf	No	Paper Only
Form	DTRA Form 150-A	Questionnaire for Continental United States Test Participants	DTRA Form 150-A - Continental Questionnaire.pdf	No	Paper Only
Form	DTRA Form 150-B	Questionnaire for Oceanic Test Participants	DTRA Form 150-B - Oceanic Questionnaire.pdf	No	Paper Only
Form	DTRA Form 150-C	Questionnaire for Crossroads Test Participants	DTRA Form 150-C - Xroads Questionnaire.pdf	No	Paper Only

Line of Business: Defense and National Security

Subfunction: Operational Defense

Privacy Act System of Records

Title: Nuclear Test Participants

FR Citation: 70 FR 46154

Number of Respondents: 370

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	370	370
Annual IC Time Burden (Hours)	463	463
Annual IC Cost Burden (Dollars)	11,563	11,563

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
DoD PIA for NTPR	DoD PIA for NTPR - 06 Oct 2006.pdf	02/01/2008
DoD Radiation and Secrecy Agreements	DOD_Radiation_&_Secrecy_Agreements.pdf	02/01/2008

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