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OMB Control No: 3150-0005	ICR Reference No: 202311-3150-004
Status: Active	Previous ICR Reference No: 202007-3150-005
Agency/Subagency: NRC	Agency Tracking No:
Title: NRC Form 4, Cumulative Occupational Dose History
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR: No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 07/30/2024
	Date Received in OIRA: 11/21/2023
Terms of Clearance: In accordance with 5 CFR 1320, this information collection is approved for 3 years.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	07/31/2027	36 Months From Approved	07/31/2024
Responses	243,429	0	241,014
Time Burden (Hours)	66,558	0	65,954
Cost Burden (Dollars)	6,877	0	6,533

Abstract: The NRC Form 4 is used to record the summary of an occupational worker’s cumulative occupational radiation dose, including prior occupational exposure and the current year’s occupational radiation exposure. The NRC Form 4 is used by licensees, and inspected by the NRC, to ensure that occupational radiation doses do not exceed the regulatory limits specified in 10 CFR 20.1501.

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:
	88 FR 59951	08/30/2023
30-day Notice:	Federal Register Citation:	Citation Date:
	88 FR 81112	11/21/2023
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 4, Cumulative Occupational Dose History	NRC Form 4, Not applicable	,

ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to Adjustment in Estimate
Annual Number of Responses	243,429	241,014	2,415
Annual Time Burden (Hours)	66,558	65,954	604
Annual Cost Burden (Dollars)	6,877	6,533	344

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 estimated burden has increased by 604 hours from the previous burden of 65,954 hours to 66,558 hours. The burden increase is primarily due an increase in respondents that are not subject to 10 CFR 20.2206(a) but must still maintain these records using an NRC Form 4 or equivalent. The number of licensees that fall in this category and report to REIRS may vary from year to year and was 9,860 responses higher compared to the previous renewal in 2020. This led to a 539-hour increase in recordkeeping and a 64-hour increase in third party disclosure burden estimates. The recordkeeping burden increased from 58,747 hours to 59,286 hours, mainly due to the higher number of non-material licensees reporting. It should be noted that the NRC does not anticipate any planned special exposures during the next three years. Additional costs associated with records storage have increased from $6,533 to $6,877 (an increase of $344) due to an increase in the fee rate used to calculate the costs. The fee rate has increased from $278 to $290 per hour. Because the recordkeeping burden is estimated to be 59,286 hours, the storage cost for this clearance is $ 6,877 (59,286 hours x 0.0004 x $290/h).

Annual Cost to Federal Government: $151,960

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: Terry Brock 301 415-7000

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