NRC Form 212, Qualifications Investigation, Professional, Technical, and Administrative Positions, (other than clerical positions)

Forms and Documents

Document Name	Status
Form NRC Form 212 NRC Form 212, Qualifications Investigation, Professional, Technical, and Administrative Positions, (other than clerical positions) Form	Modified
Final Form 212 SS 110110.docx Supporting Statement A	2010-11-05

IC Document Collections

IC ID	Document Title	Status
33255	NRC Form 212, Qualifications Investigation, Professional, Technical, and Administrative Positions, (other than clerical positions) Form	Modified

ICR Details

OMB Control No: 3150-0033	ICR Reference No: 201011-3150-001
Status: Historical Active	Previous ICR Reference No: 200707-3150-001
Agency/Subagency: NRC	Agency Tracking No:
Title: NRC Form 212, Qualifications Investigation, Professional, Technical, and Administrative Positions, (other than clerical positions)
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 03/22/2011
	Date Received in OIRA: 11/05/2010
Terms of Clearance: In accordance with 5 CFR 1320, the information collection is approved for 3 years.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	03/31/2014	36 Months From Approved	03/31/2011
Responses	1,000	0	1,200
Time Burden (Hours)	500	0	300
Cost Burden (Dollars)	0	0	0

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Abstract: Information requested on NRC Form 212, “Qualifications Investigation, Professional, Technical, and Administrative Positions (other than clerical positions)” is used to determine the qualifications and suitability of external applicants for employment with NRC. The completed form may be used to examine, rate and/or assess the prospective employee’s qualifications. The information regarding the qualifications of applicants for employment is reviewed by professional personnel of the Office of Human Resources, in conjunction with other information in the NRC files, to determine the qualifications of the applicant for appointment to the position under consideration.

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Authorizing Statute(s): PL: Pub.L. 83 - 703 1-311 Name of Law: Atomic Energy Act of 1954
  

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:
	75 FR 17167	04/05/2010
30-day Notice:	Federal Register Citation:	Citation Date:
	75 FR 66394	10/28/2010
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 Form 212, Qualifications Investigation, Professional, Technical, and Administrative Positions, (other than clerical positions)	NRC Form 212	Qualifications Investigation, Professional, Technical, and Administrative Positions (Other than clearical positions)

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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	1,000	1,200	0	0	-200	0
Annual Time Burden (Hours)	500	300	0	0	200	0
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: The overall burden has increased by 200 hours from 300 to 500 hours because (1) a reduction in the number of references and (2) the combining of NRC Form 212A with NRC Form 212. Based on guidance from OPM regarding reference checks, the NRC has determined that the questions are virtually the same regardless of position; therefore the NRC will discontinue the use of NRC Form 212A. Although the burden per response will increase from 15 minutes to 30 minutes, the number of responses will decrease from an estimated 1,200 to 1,000 forms, based on the number of references required. This burden change will result in an estimated burden of 500 hours (1,000 forms X .50 hrs) at a cost of $128,500 (500 hrs X $257).

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Annual Cost to Federal Government: $128,500

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: 11/05/2010

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