View Information Collection Request (ICR) Package
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Please note that the OMB number and expiration date may not have been determined when this Information Collection Request and associated Information Collection forms were submitted to OMB. The approved OMB number and expiration date may be found by clicking on the Notice of Action link below.
View ICR - OIRA Conclusion
OMB Control No:
3150-0024
ICR Reference No:
202303-3150-002
Status:
Active
Previous ICR Reference No:
202205-3150-006
Agency/Subagency:
NRC
Agency Tracking No:
Title:
NRC Form 396, Certification of Medical Examination by Facility Licensee
Type of Information Collection:
No material or nonsubstantive change to a currently approved collection
Common Form ICR:
No
Type of Review Request:
Regular
OIRA Conclusion Action:
Approved with change
Conclusion Date:
05/18/2023
Retrieve Notice of Action (NOA)
Date Received in OIRA:
03/20/2023
Terms of Clearance:
In accordance with 5 CFR 1320, the non-substantive change request is approved.
Inventory as of this Action
Requested
Previously Approved
Expiration Date
12/31/2025
12/31/2025
12/31/2025
Responses
1,778
0
1,778
Time Burden (Hours)
2,063
0
2,063
Cost Burden (Dollars)
48
0
48
Abstract:
NRC Form 396 is used to transmit information to the NRC regarding the medical condition of applicants for initial operator licenses or renewal of operator licenses and for the maintenance of medical records for all licensed operators. The information is used to determine whether the physical condition and general health of applicants for operator licensees is such that the applicant would not be expected to cause operational errors and endanger public health and safety.
Authorizing Statute(s):
PL:
Pub.L. 83 - 703 1-311
Name of Law: Atomic Energy Act
Citations for New Statutory Requirements:
None
Associated Rulemaking Information
RIN:
Stage of Rulemaking:
Federal Register Citation:
Date:
Not associated with rulemaking
Federal Register Notices & Comments
60-day Notice:
Federal Register Citation:
Citation Date:
87 FR 5520
02/01/2022
30-day Notice:
Federal Register Citation:
Citation Date:
87 FR 33215
06/01/2022
Did the Agency receive public comments on this ICR?
No
Number of Information Collection (IC) in this ICR:
1
IC Title
Form No.
Form Name
NRC Form 396, Certification of Medical Examination by Facility Licensee
NRC FORM 396, NRC Form 396
CERTIFICATION OF MEDICAL EXAMINATION BY FACILITY LICENSEE with EDITS
,
CERTIFICATION OF MEDICAL EXAMINATION BY FACILITY LICENSEE - Current Form
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
1,778
1,778
0
0
0
0
Annual Time Burden (Hours)
2,063
2,063
0
0
0
0
Annual Cost Burden (Dollars)
48
48
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 burden for the information collection decreased from 2,196 hours to 2,063 hours, a decrease of 133 hours. The number of total responses overall has decreased from 1,882 (1,757 responses + 125 recordkeepers) to 1,778 (1,650 Responses + 128 Recordkeepers), a decrease of 104 responses. However, due to a data entry oversight in the previous cycle, recordkeepers were not included in the total number of responses, therefore ROCIS totals show an increase of 21 responses in this submission. NRC Form 396 is the mechanism by which NRC is advised of the applicant/operator general health and physical condition, and when a facility and/or individual is no longer subject to the requirements of 10 CFR Part 55, they will no longer submit NRC Form 396. Therefore, the decrease in projected submissions is due to the decrease in licensed individuals and operating reactor plants being subject to Part 55 requirements. There is a projected minimal increase in respondents up from 125 (94 operating reactors + 31 research and test reactor facilities) in the prior cycle to 128 (89 operating reactors + 31 research and test reactor facilities + 8 combined operating license holders), this increase is due to the addition of eight Combined Operating License Holders who are subjected to the requirements of 10 CFR Part 55 and a reduction of 5 operating reactor facilities no longer licensed and are not subject to the requirements of 10 CFR Part 55. There is an approximately 50% increase in NRC Contractor Licensed Physician review fee per form per agreed contract. There is a minimal increase in projected disability submissions, up 10 submissions annually from 530 in the prior cycle to 540 for this cycle. Staff believes this is a reasonable projection in line with current health trend data. Additionally, NRC currently uses the EIE, OSM, facsimile, or e-mail to deliver NRC Form 396s and receive the completed medical reviews from the NRC Contractor. The agency no longer uses mailing/shipping services to deliver forms to the NRC Contractor, which eliminated the prior mailing/shipping costs.
Annual Cost to Federal Government:
$180,444
Does this IC contain surveys, censuses, or employ statistical methods?
No
Does this ICR request any personally identifiable information (see
OMB Circular No. A-130
for an explanation of this term)? Please consult with your agency's privacy program when making this determination.
No
Does this ICR include a form that requires a Privacy Act Statement (see
5 U.S.C. §552a(e)(3)
)? Please consult with your agency's privacy program when making this determination.
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?
No
Agency Contact:
Ikeda Betts 301 415-1959
Common Form ICR:
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:
(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:
03/20/2023
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