NRC Forms 850A "Request for NRC Contractor Building Access," 850B "Request for NRC Contractor Information Technology Access Authorization," and 850C "Request for NRC Contractor Security Clearance"

Forms and Documents

Document Name	Status
Form NRC Form 850C NRC Forms 850A, 850B, and 850C Form and Instruction	New
Final SS for NRC Form 850 Series.doc Supporting Statement A	2013-11-04

IC Document Collections

IC ID	Document Title	Status
209500	NRC Forms 850A, 850B, and 850C Form and Instruction	New

ICR Details

OMB Control No: 3150-0218	ICR Reference No: 201308-3150-004
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: NRC	Agency Tracking No:
Title: NRC Forms 850A "Request for NRC Contractor Building Access," 850B "Request for NRC Contractor Information Technology Access Authorization," and 850C "Request for NRC Contractor Security Clearance"
Type of Information Collection: Existing collection in use without an OMB Control Number	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 03/11/2014
	Date Received in OIRA: 12/26/2013
Terms of Clearance: In accordance with 5 CFR 1320, the information collection is approved for three years. The agency PRA office is reminded to have in place the appropriate levels of communication with program staff to ensure that information collections are submitted to OMB for approval prior to collecting any information from the public.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	03/31/2017	36 Months From Approved
Responses	500	0	0
Time Burden (Hours)	85	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: 10 CFR Part 10, "Criteria and Procedures for Determining Eligibility for Access to Restricted Data or National Security Information or an Employment Clearance," establishes requirements that individuals requiring an access authorization and/or employment clearance must have an investigation of their background. NRC Forms 850A, 850B, and 850C will be used by the NRC to obtain information on NRC contractors, subcontractors, and other individuals who are not NRC employees and require access to NRC buildings, IT systems, sensitive information, sensitive unclassified information, or classified information.

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Authorizing Statute(s): EO: EO 12968 Name/Subject of EO: Access to Classified Information
   EO: EO 10450 Name/Subject of EO: Security Requirements for Government Employment
   EO: EO 13488 Name/Subject of EO: Granting Reciprocity on Excepted Service and Federal Contractor Employee Fitness...
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	78 FR 22562	04/16/2013
30-day Notice:	Federal Register Citation:	Citation Date:
	78 FR 48502	08/08/2013
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
NRC Forms 850A, 850B, and 850C	NRC Form 850B, NRC Form 850C, NRC Form 850A	Request for NRC Contractor Security Clearance ,   Request for NRC Contractor Building Access Authorization ,   Request for NRC Contractor Information Technology Access Authorization

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ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	500	0	0	0	0	500
Annual Time Burden (Hours)	85	0	0	0	0	85
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement:

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Annual Cost to Federal Government: $14,955

Does this IC contain surveys, censuses, or employ statistical methods? No

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 12/26/2013

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