Form NRC Form 509 NRC Form 509 Statement of Estimated Fees for Freedom of Information A

NRC FORM 509

U.S. NUCLEAR REGULATORY COMMISSION
APPROVED BY OMB: 3150-0043
EXPIRES: MM/DD/YYYY

(M-YYYY)

STATEMENT OF ESTIMATED FEES FOR
FREEDOM OF INFORMATION ACT (FOIA) REQUEST
REQUESTER

NRC CONTACT

REQUEST NUMBER

FOIA/PA DATE

TELEPHONE

Pursuant to the NRC's regulations, 10 CFR 9.40, 52 FR 49350, the NRC notifies a requester when estimated applicable fees exceed
$25.00 or a limit stated in an FOIA request. The estimated fees for processing your FOIA request are noted below. If you wish to
re-scope your request to reduce fees, you may telephone the NRC contact identif ied above to discuss re-scoping the request.
Otherwise, please provide a written response on required action noted below. I f the NRC does not receive notice from you on
re-scoping your request or the required written response within 10 working days from the date of this notice, the NRC will presume
that you have no further interest in NRC processing your request and will close the file on your request.

ESTIMATED FEES
SEARCH

$

REVIEW

$

DUPLICATION *

$

TOTAL

$

0.00

* Duplication estimate is based on the assumption that you want copies of disclosed records mailed directly to you. If you
prefer, the NRC will make disclosed records available, if appropriate, at the NRC Electronic Reading Room accessible
from NRC's web site at http://www.nrc.gov. Please note your preference in the Response section below.
Please note the comments provided on the attached NRC Form 509A.
For fee purposes, the NRC has aggregated the multiple requests identified above under the presumption that the
requested records could have been the subject of a single request.
Your request for a waiver or reduction of fees does not provide sufficient information under 10 CFR 9.41 for the
NRC to make a determination to waive or reduce fees. If you want the NRC to consider this matter further, please
submit a written request pursuant to 10 CFR 9.41 within 10 working days from the receipt of this notice.
REQUIRED ACTION
Please agree in writing to pay fees as high as estimated by signing and dating the Response section of this form
and returning the form to the NRC contact identified above at the U.S. Nuclear Regulatory Commission,
Washington, DC, 20555-0001, within 10 working days from the date of this notice.
Please provide an advance payment of the estimated fees by one of the methods described on the attached NRC
Form 509A within 10 working days from the date of this notice. Any overpayment of fees will be refunded to you.
SIGNATURE - FOIA/PA SPECIALIST

RESPONSE
As required above, I agree to pay fees as high as estimated. I agree to pay estimated search fees even if the NRC
conducts an unsuccessful search for responsive records or determines records located are exempt from disclosure. I
prefer that copies of disclosed records be provided as stated below.
Mailed directly to me.
SIGNATURE - FOIA/PA REQUESTER

NRC FORM 509 (M-YYYY)
PRINTED ON RECYCLED PAPER

Placed in the NRC Electronic Reading Room.
DATE

Estimated burden per response to comply with this mandatory collection request: 6 minutes. This form is used to notify a requester of the amount of the
estimated fees and to obtain the requester's agreement to pay the fees. Send comments regarding burden estimate to the Records Management Branch
(T-5 F11), U.S. Nuclear Regulatory Commission, Washington, DC 20555-0001, or by internet e-mail to [email protected], and to the Desk
Officer, Office of Information and Regulatory Affairs, NEOB-10202, (3150-0043), Office of Management and Budget, Washington, DC 20503. If a means
used to impose an information collection does not display a currently valid OMB control number, the NRC may not conduct or sponsor, and a person is
not required to respond to, the information collection.

NRC FORM 509A

U.S. NUCLEAR REGULATORY COMMISSION

REQUEST NUMBER

(M-YYYY)

STATEMENT OF ESTIMATED FEES FOR
FREEDOM OF INFORMATION ACT (FOIA) REQUEST
COMMENTS

FOIA/PA -

Payment may be made to the USNRC by check or credit card. If paying via credit card, the enclosed NRC Form
629 must be completed and forwarded to one of the addressees listed below. Ple ase be sure to reference the
number assigned to your request (i.e., FOIA/PA-2003-0120) on your check or in t he box marked "Invoice Number
or Description" on the enclosed NRC Form 629 if you are paying by credit card.
Your check or NRC Form 629 should be mailed to the attention of the NRC Contact identified on the previous
page at the following address:
Mail Stop T-5 F11
USNRC
Washington, DC 20555-0001
Payments sent via an overnight delivery method should be sent to the NRC Contac t identified on the previous page
at:
Mail Stop T-5 F11
USNRC
11555 Rockville Pike
Rockville, MD 20852-2738

NRC FORM 509A (M-YYYY)

PRINTED ON RECYCLED PAPER

NRC FORM 509A

U.S. NUCLEAR REGULATORY COMMISSION

REQUEST NUMBER

(M-YYYY)

STATEMENT OF ESTIMATED FEES FOR
FREEDOM OF INFORMATION ACT (FOIA) REQUEST
COMMENTS

FOIA/PA -

COMMENTS

NRC FORM 509A (M-YYYY)

PRINTED ON RECYCLED PAPER