Radioactive Material Transfer Receipt

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form JSC Form 1625 Radioactive Material Transfer Receipt	Form and Instruction	Unchanged	Available
2700-0007 Supporting Statement.doc	Supporting Statement B	Uploaded 2008-09-16	Available
2700-0007 Supporting Statement.doc	Supporting Statement A	Uploaded 2008-09-16	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
27944	Radioactive Material Transfer Receipt	Form and Instruction	Unchanged

ICR Details

OMB Control No: 2700-0007	ICR Reference No: 201012-2700-017
Status: Historical Inactive	Previous ICR Reference No: 200809-2700-001
Agency/Subagency: NASA	Agency Tracking No:
Title: Radioactive Material Transfer Receipt
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Withdrawn	Conclusion Date: 01/26/2011
	Date Received in OIRA: 12/29/2010
Terms of Clearance: At the request of the Agency, this collection is withdrawn from OMB review

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date		36 Months From Approved	10/31/2011
Responses	0	0	50
Time Burden (Hours)	0	0	10
Cost Burden (Dollars)	0	0	850

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Abstract: NASA Johnson Space Center is licensed to collect and maintain records of radioactive material used for space-related activities at temporary job sites in the U.S. Information collected includes descriptions, transfer, location, and disposition of materials and records of accountability. Respondents are NASA field centers, contractors, and subcontractors and vendors.

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Authorizing Statute(s): None

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	10 FR 134	10/26/2010
30-day Notice:	Federal Register Citation:	Citation Date:
	10 FR 166	12/21/2010
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

table that charts list of burden

IC Title	Form No.	Form Name
Radioactive Material Transfer Receipt	JSC Form 1625	Radioactive Material Transfer Receipt

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Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement:

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Annual Cost to Federal Government: $10,000

Does this IC contain surveys, censuses, or employ statistical methods? No

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 12/29/2010

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