Information Collection

Nuclear Test Personnel Review Forms

IC 181351 under ICR 201710-0704-005 · OMB 0704-0447.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0704-0447 can be found here:

Documents and Forms

Document Name Document Type
Form DTRA Form 150 Nuclear Test Personnel Review Forms Form
9.13 119-NEWTIF 070612_Phone Transcript.pdf Other-Phone Transcript Form
9.13 Letter with Questionaire.doc Instruction
DTRA Form 150 Nuclear Test Personnel Review Information Request and Re 9.13 150 Sept.doc Form
DTRA Form 150-A Nuclear Test Personnel Review Program: Questionnaire for 9.13 150A Sept.docx Form
DTRA Form 150-B Nuclear Test Personnel Review Program: Questionnaire for 9.13 150 B Sept.docx Form
DTRA Form 150-C Nuclear Test Personnel Review Program: Questionnaire for 9.13 150 C Sept.docx Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Nuclear Test Personnel Review Forms	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 32 CFR 218

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Electronic Capability
Form	DTRA Form 150	Nuclear Test Personnel Review Information Request and Release	9.13 150 Sept.doc	No	Paper Only
Form	DTRA Form 150-A	Nuclear Test Personnel Review Program: Questionnaire for Continental United States Test Participants	9.13 150A Sept.docx	No	Paper Only
Form	DTRA Form 150-B	Nuclear Test Personnel Review Program: Questionnaire for Oceanic Test Participants	9.13 150 B Sept.docx	No	Paper Only
Form	DTRA Form 150-C	Nuclear Test Personnel Review Program: Questionnaire for CROSSROADS Test Participants	9.13 150 C Sept.docx	No	Paper Only
Other-Phone Transcript Form			9.13 119-NEWTIF 070612_Phone Transcript.pdf	No	Paper Only
Instruction			9.13 Letter with Questionaire.doc	No	Paper Only

Line of Business: Defense and National Security

Subfunction: Operational Defense

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 86	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion	Change Due to Potential Violation of the PRA
Annual Number of Responses for this IC	86	-284	370
Annual IC Time Burden (Hours)	71	-392	463
Annual IC Cost Burden (Dollars)	1,574	-9,989	11,563

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.