NRC Form 509 Statement of Estimated Fees for Freedom of Information A

NRC FORM 509

U. S. NUCLEAR REGULATORY COMMISSION
APPROVED BY OMB: 3150-0043
EXPIRES: (MM/DD/YYYY)

(MM-DD-YYYY)

STATEMENT OF ESTIMATED FEES FOR FREEDOM OF
INFORMATION ACT (FOIA) REQUEST
Requester

NRC Contact

FOIA OR REFERENCE NUMBER

DATE

Telephone Number (Enter 10 numeric digits)

SECTION I - ESTIMATED FEES
Pursuant to the NRC's regulations, 10 CFR 9.40, www.nrc.gov/reading-rm/doc-collections/cfr/part009, the NRC notifies
you when estimated applicable fees exceed $25.00, or a limit stated in your FOIA request. Please telephone the NRC
contact identified above if you wish to discuss re-scoping your request to reduce the estimated fees:

ESTIMATED FEES
SEARCH

REVIEW

TOTAL

Unless you indicate otherwise in Section II, below, the NRC's response to your FOIA request, including any disclosed
records, will be provided to you electronically. When we provide our response electronically, you are not charged any
duplication fees.
SECTION II - ACTION REQUIRED OF REQUESTER
Since the estimated fees are $250 or less, I am agreeing to pay fees as high as estimated.
Since the estimated fees exceed $250, I am providing an advance payment of the estimated fees.
Payments must be made through www.pay.gov, by checking the box “Other” and entering the FOIA
request number.
Check here if you prefer to receive our response, and any disclosed records, on paper. If you choose this
option, you will also be charged duplication fees. If you check this box, we will supplement the fee estimate
by providing you with an updated Form 509 showing the duplication cost. If this amount exceeds $250.00,
you must submit an advance payment in that amount.
By signing this form, below, I understand that the NRC can charge me search and review fees, as applicable, even if the
search does not locate records, or the records are determined to be exempt from disclosure.
In accordance with 10 CFR § 9.39(f)(1), if the NRC fails to comply with any time limit under §§ 9.25 or 9.29, it may not
charge search fees or, in the case of requests from requesters described in § 9.33(a)(2), may not charge duplication
fees, except under certain circumstances specified in §§ 9.39(f)(2)-(4).
You must complete this form, sign and date it, and return it to the NRC, to the attention of the NRC contact identified
above. If we do not hear from you about re-scoping your request, or we do not receive this completed form back from
you, by
, we will presume that you have no further interest in pursuing your request, and we will
close our file on this matter.
Signature - FOIA Requester

Signature Date

Estimated burden per response to comply with this mandatory collection request: 6 minutes. This form is used to notify a requester of the amount of the estimated fees and to obtain the requesters agreement to
pay the fees. Send comments regarding burden estimate to the FOIA, Library, and Information Collections Branch (T-6 A10M), U.S. Nuclear Regulatory Commission, Washington, DC 20555-0001, or by email to
[email protected], and the OMB reviewer at: OMB Office of Information and Regulatory Affairs, (3150-0043), Attn: Desk Officer for the Nuclear Regulatory Commission, 725 17th Street NW,
Washington, DC 20503. The NRC may not conduct or sponsor, and a person is not required to respond to, a collection of information unless the document requesting or requiring the collection displays a
currently valid OMB control number.
NRC Form 509 (MM-DD-YYYY)