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Federal forms, ICRs, and supporting documents

Information Collection Request

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"

ICR 201612-3150-003 · OMB 3150-0218 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
Form NRC Form 850A NRC Forms 850A, 850B, and 850C Form and Instruction Modified Available
2016-31324.pdf Supplementary Document Uploaded 2017-01-03 Available
OMB 3150-0218_Final SS for NRC Form 850 Series.doc Supporting Statement A Uploaded 2016-12-20 Repair queued
IC Document Collections
IC IDCollectionTypeStatusForm
209500 NRC Forms 850A, 850B, and 850C Form and Instruction Modified
ICR Details
3150-0218 201612-3150-003
Historical Active 201308-3150-004
NRC
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"
Extension without change of a currently approved collection   No
Regular
Approved without change 03/27/2017
Retrieve Notice of Action (NOA) 01/04/2017
  Inventory as of this Action Requested Previously Approved
03/31/2020 36 Months From Approved 03/31/2017
500 0 500
85 0 85
0 0 0
Part 10 of title 10 of the Code of Federal Regulations, ‘‘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 the NRC’s contractors, subcontractors, and other individuals who are not NRC employees and require access to the NRC buildings, IT systems, sensitive information, sensitive unclassified information, or classified information.
EO: EO 10450 Name/Subject of EO: Security Requirements for Government Employment
   EO: EO 12968 Name/Subject of EO: Access to Classified Information
   EO: EO 13488 Name/Subject of EO: Granting Reciprocity on Excepted Service and Federal Contractor Employee Fitness...
  
None
Not associated with rulemaking
  81 FR 62546 09/09/2016
81 FR 95656 12/28/2016
No
  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 500 500 0 0 0 0
Annual Time Burden (Hours) 85 85 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No
$14,715
No
No
No
No
No
Uncollected
Emily Robbins 3014150320
  No
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:
 
 
 
 
 
 
 
    (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;
 
 
 
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.
01/04/2017