Information Collection

NRC Form 212A, Qualifications Investigation, Secretarial/Clerical

IC 33258 under ICR 201011-3150-002 · OMB 3150-0034.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form NRC Form 212A Qualifications Investigation, Secretarial/Clerical NRC Form 212A, Qualifications Investigation, Secretarial/Clerical	Form
NRC Form 212A Qualifications Investigation, Secretarial/Clerical NRC Form 212A.pdf	Form

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	NRC Form 212A				Yes	No	Fillable Printable

Line of Business: Workforce Management

Subfunction: Training and Employment

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 400

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	Previously Approved
Annual Number of Responses for this IC	400	400
Annual IC Time Burden (Hours)	100	100
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
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.

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