Information Collection

10 CFR 95, Facility Security Clearance and Safeguarding of National Security Information and Restricted Data

IC 33294 under ICR 202412-3150-003 · OMB 3150-0047.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form NRC Form 405F 10 CFR 95, Facility Security Clearance and Safeguarding of National Security Information and Restricted Data	Form and Instruction
Form NRC Form 405F List ALL Owners, Officers, Directors, and Executive Personnel (OODEP's) 10 CFR 95, Facility Security Clearance and Safeguarding of National Security Information and Restricted Data	Form and Instruction
NRC Form 405F List ALL Owners, Officers, Directors, and Executive Pers NRC 405F (New OMB Copy 4)(04-16-2024).pdf	Form and Instruction
NRC Form 405F List ALL Owners, Officers, Directors, and Executive Pers NRC 405F (New OMB Copy 4)(04-16-2024).pdf	Form and Instruction

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 10 CFR 95

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	NRC Form 405F				Yes	Yes	Fillable Fileable

Line of Business: Energy

Subfunction: Energy Production

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 20

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 50 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	156	12	144
Annual IC Time Burden (Hours)	940	276	664
Annual IC Cost Burden (Dollars)	20	1	19

Documents for IC

table that charts IC Documents
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.

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