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NRC Form 396, Certification of Medical Examination by Facility Licensee

IC 33230 under ICR 202512-3150-001 · OMB 3150-0024.

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Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
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NRC Form 396, Certification of Medical Examination by Facility Licensee
 
No Modified
 
Mandatory
 
10 CFR 55

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction NRC Form 396 ONLINE FORM -CERTIFICATION OF MEDICAL EXAMINATION BY FACILITY LICENSEE New 396 web version updated 8_6 (2)_WITH EDITS 12_8_2025.pdf Yes Yes Fillable Fileable
Form and Instruction NRC Form 396 FORM 396 -CERTIFICATION OF MEDICAL EXAMINATION BY FACILITY LICENSEE NRC 396 (OMB Copy 3) (12-08-2025) KB.pdf Yes Yes Fillable Fileable

Energy Energy Resource Management

NRC 16: Facility Operator Licensee Records  84 FR 71536

133 0
   
Private Sector Businesses or other for-profits
 
   100 %

  Approved 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 1,862 0 0 84 0 1,778
Annual IC Time Burden (Hours) 2,161 0 0 98 0 2,063
Annual IC Cost Burden (Dollars) 55 0 0 7 0 48

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