Information Collection Request

NRC Form 4, Cumulative Occupational Exposure History

ICR 201006-3150-005 · OMB 3150-0005 · Historical Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form NRC Form 4 NRC Form 4, Cumulative Occupational Exposure History Form and Instruction Modified Available
Final Form 4 SS 102810.doc Supporting Statement A Uploaded 2010-10-28 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
33127 NRC Form 4, Cumulative Occupational Exposure History Form and Instruction Modified

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
03/31/2014 36 Months From Approved 03/31/2011
3,848 0 257
18,410 0 64
0 0 0





Reginfo record details
1
table that charts list of burden
IC Title Form No. Form Name
NRC Form 4, Cumulative Occupational Exposure History NRC Form 4 Cumulative Occupational Exposure History

table that charts list of burden
  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 3,848 257 0 0 3,591 0
Annual Time Burden (Hours) 18,410 64 0 0 18,346 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No