Human Reliability Program

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1910-5122 can be found here:

Documents and Forms

Document Name Document Type
Form DOE F 470.3 Human Reliability Program Form
DOE F 470.3 Human Reliability Program (HRP) Certification 470-3 Revised 5-15-13.docx Form
DOE F 470.4 Acknowledgement and Agreement to Participate in the Huma 470-4 Revised 5-15-13.docx Form
DOE F 470.5 Authorization and Consent to Release Human Reliability P 470-5 Revised 5-15-13.docx Form
DOE F 470.6 Refusal of Consent 470-6.pdf Form
DOE F 470.7 Human Reliability Program Alcohol Testing 470-7.pdf Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Human Reliability Program	Agency IC Tracking Number:	Felecia Briggs

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 10 CFR 712

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	DOE F 470.3	Human Reliability Program (HRP) Certification	470-3 Revised 5-15-13.docx	Yes	No	Printable Only
Form	DOE F 470.4	Acknowledgement and Agreement to Participate in the Human Reliability Program	470-4 Revised 5-15-13.docx	Yes	No	Printable Only
Form	DOE F 470.5	Authorization and Consent to Release Human Reliability Program Records in Connection with HRP	470-5 Revised 5-15-13.docx	Yes	No	Printable Only
Form	DOE F 470.6	Refusal of Consent	470-6.pdf	Yes	No	Printable Only
Form	DOE F 470.7	Human Reliability Program Alcohol Testing	470-7.pdf	Yes	No	Printable Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 43,960	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	43,999	33,659	10,340
Annual IC Time Burden (Hours)	3,873	-2,331	6,204
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

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.