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NRC Form 893, "Single FFD Policy Violation Form," and NRC Form 894, "Annual Reporting Form for FFD Information"
NRC Form 893, “Single FFD Policy Violation Form,” and NRC Form 894, “Annual Reporting Form for FFD Information"
OMB:
IC ID: 271952
OMB.report
NRC
ICR 202410-3150-013
IC 271952
( )
Documents and Forms
Document Name
Document Type
Form NRC Form 893
NRC Form 893, "Single FFD Policy Violation Form," and NRC Form 894, "Annual Reporting Form for FFD Information"
Form
DG-5073 - Fitness-For-Duty Programs For Commercial Nuclear Plants And Manufacturing Facilities Licensed Under 10 CFR Part 53.doc
Instruction
NRC Form 893 Part 26 Subpart M Single FFD Policy Violation Form
NRC Form 893, Part 26 Subpart M Single FFD Policy Violation Form.pdf
Form
NRC Form 894 Part 26 Subpart M, Annual Reporting Form for FFD Perform
NRC Form 894, Part 26 Subpart M, Annual Reporting Form for FFD Performance Information.pdf
Form
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
NRC Form 893, "Single FFD Policy Violation Form," and NRC Form 894, "Annual Reporting Form for FFD Information"
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
New
Obligation to Respond:
Mandatory
CFR Citation:
10 CFR 26
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form
NRC Form 893
Part 26 Subpart M Single FFD Policy Violation Form
NRC Form 893, Part 26 Subpart M Single FFD Policy Violation Form.pdf
Yes
Yes
Fillable Fileable
Form
NRC Form 894
Part 26 Subpart M, Annual Reporting Form for FFD Performance Information
NRC Form 894, Part 26 Subpart M, Annual Reporting Form for FFD Performance Information.pdf
Yes
Yes
Fillable Fileable
Instruction
DG-5073 - Fitness-For-Duty Programs For Commercial Nuclear Plants And Manufacturing Facilities Licensed Under 10 CFR Part 53.docx
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Energy
Subfunction:
Energy Resource Management
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
1
Number of Respondents for Small Entity:
0
Affected Public:
Private Sector
Private Sector:
Businesses or other for-profits
Percentage of Respondents Reporting Electronically:
100 %
Requested
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
1
1
0
0
0
0
Annual IC Time Burden (Hours)
1
1
0
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
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.