Information Collection

Nuclear Test Personnel Review Forms

IC 181351 under ICR 202402-0704-012 · OMB 0704-0447.

Documents and Forms

Document Name Document Type
Form DTRA Form 150 Nuclear Test Personnel Review Forms Form
DTRA Form 150 Nuclear Test Personnel Review Information Request and Re DTRA Form 150 - Information Release.docx Form
DTRA Form 150 Nuclear Test Personnel Review Information Request and Re DTRA Form 150 - Information Release.docx Form
DTRA Form 150-A Questionnaire for Continental United States Test Partici DTRA Form 150 A - Continental Questionnaire.docx Form
DTRA Form 150-A Questionnaire for Continental United States Test Partici DTRA Form 150 A - Continental Questionnaire.docx Form
DTRA Form 150 B Questionnaire for Oceanic Test Participants DTRA Form 150 B - Oceanic Questionnaire.docx Form
DTRA Form 150 B Questionnaire for Oceanic Test Participants DTRA Form 150 B - Oceanic Questionnaire.docx Form
DTRA Form 150 D Atomic Veterans Service Certificate Application and Nucl DTRA Form 150 D - AVSC Application.docx www.dtra.mil/Portals/61/Documents/NTPR/7-AVSC/DTRA%20Form%20150-D-AVSC%20Application.pdf?ver=2020-03-25-112604-437 Form
DTRA Form 150 D Atomic Veterans Service Certificate Application and Nucl DTRA Form 150 D - AVSC Application.docx www.dtra.mil/Portals/61/Documents/NTPR/7-AVSC/DTRA%20Form%20150-D-AVSC%20Application.pdf?ver=2020-03-25-112604-437 Form
Letter with Questionnaires.docx Letter with Questionnaires IC Document
Letter with Questionnaires.docx Letter with Questionnaires IC Document
Phone Corresponence Log Sheet.pdf Phone Log Correspondence Sheet IC Document
Phone Corresponence Log Sheet.pdf Phone Log Correspondence Sheet IC Document

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: Voluntary

CFR Citation: 32 CFR 218

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	DTRA Form 150	Nuclear Test Personnel Review Information Request and Release	DTRA Form 150 - Information Release.docx		No		Paper Only
Form	DTRA Form 150-A	Questionnaire for Continental United States Test Participants	DTRA Form 150 A - Continental Questionnaire.docx		No		Paper Only
Form	DTRA Form 150 B	Questionnaire for Oceanic Test Participants	DTRA Form 150 B - Oceanic Questionnaire.docx		No		Paper Only
Form	DTRA Form 150 D	Atomic Veterans Service Certificate Application and Nuclear Test Personnel Review Information Request and Release	DTRA Form 150 D - AVSC Application.docx	https://www.dtra.mil/Portals/61/Documents/NTPR/7-AVSC/DTRA%20Form%20150-D-AVSC%20Application.pdf?ver=2020-03-25-112604-437	Yes	No	Printable Only

Federal Enterprise Architecture Business Reference Module

Line of Business: Defense and National Security

Subfunction: Operational Defense

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 278	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	Previously Approved
Annual Number of Responses for this IC	278	0	278
Annual IC Time Burden (Hours)	113	0	113
Annual IC Cost Burden (Dollars)	3,466	749	2,717

Documents for IC

Title	Document	Date Uploaded
Letter with Questionnaires	Letter with Questionnaires.docx	10/07/2020
Phone Log Correspondence Sheet	Phone Corresponence Log Sheet.pdf	10/07/2020

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.