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View ICR - OIRA Conclusion

OMB Control No: 3150-0024	ICR Reference No: 202512-3150-001
Status: Active	Previous ICR Reference No: 202303-3150-002
Agency/Subagency: NRC	Agency Tracking No:
Title: NRC Form 396, Certification of Medical Examination by Facility Licensee
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: 04/15/2026
	Date Received in OIRA: 12/23/2025
Terms of Clearance: In accordance with 5 CFR 1320, the information collection is approved. Please consider the options contemplated in public comments to maximize the practical utility of the collection and minimize the burden including efforts that may include a future rulemaking.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	04/30/2029	36 Months From Approved	04/30/2026
Responses	1,862	0	1,778
Time Burden (Hours)	2,161	0	2,063
Cost Burden (Dollars)	55	0	48

ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to Adjustment in Estimate
Annual Number of Responses	1,862	1,778	84
Annual Time Burden (Hours)	2,161	2,063	98
Annual Cost Burden (Dollars)	55	48	7

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 number of total responses has increased from 1,778 in the prior cycle to 1,862 in this cycle. 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 increase in projected submissions is due to the increase in licensed individuals, operating reactor plants, and projected license renewals being subject to Part 55 requirements. Currently, NRC uses the Electronic Information Exchange (EIE), OSM, facsimile, or e‑mail to deliver NRC Form 396 and receive the completed medical reviews from the NRC Contractor. The facility licensees submit a scanned pdf version of NRC Form 396 via EIE. NRC Form 396 was updated to clarify instructions. In addition, the fee rate has increased from $288 to $317 per hour

Annual Cost to Federal Government: $200,693

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

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