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OMB Control No: 3150-0255	ICR Reference No: 202603-3150-005
Status: Received in OIRA	Previous ICR Reference No: 202503-3150-001
Agency/Subagency: NRC	Agency Tracking No:
Title: NRC Form 646, "Formal Discrimination Complaint"
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR: No
Type of Review Request: Regular	Date Submitted to OIRA: 03/13/2026

	Requested	Previously Approved
Expiration Date	36 Months From Approved	01/31/2026
Responses	30	30
Time Burden (Hours)	30	30
Cost Burden (Dollars)	0	0

Abstract: As set forth under 29 CFR 1614, the EEO complaint process prescribes that when an aggrieved individual believes that they have been discriminated against on the basis of their race, color, religion, sex (including sexual orientation, gender identity and expressions, and pregnancy), national origin, age, disability, genetic information (including family medical history), marital status, parental status, political affiliation, military service, and reprisal and seeks EEO counseling, the assigned EEO Counselor will conduct the pre-complaint (Informal) with the intentions of resolving the complaint within the Agency. At the conclusion of pre-complaint (Informal) process and if resolution was unsuccessful, the EEO Counselor during the final interview with the aggrieved person must discuss what occurred during the counseling process and provide the aggrieved with information to move the matter forward. Pursuant to 29 CFR § 1614.105(c), if the aggrieved individual decides to file a Formal complaint (i.e., NRC Form 646), the EEO Counselor must submit a written report (i.e., EEO Counselors Report) within fifteen (15) calendar days to the SBCR Director or designated official that will contain relevant information about the aggrieved individual, jurisdiction, claims, bases, Responding Management Officials (RMO), witnesses, requested remedies, and the EEO Counselor's checklist. Once received by the NRC, an authorized NRC representative will place the completed NRC Form 646 in a secure folder created specifically for the aggrieved individual within an automated tracking system.

Authorizing Statute(s): PL: Pub.L. 88 - 352 703 Name of Law: Title VII of the Civil Rights Act of 1964, as amended
   PL: Pub.L. 93 - 112 501 Name of Law: Rehabilitation Act of 1973
   PL: Pub.L. 90 - 202 621 Name of Law: Age Discrimination in Employment Act of 1967
   PL: Pub.L. 88 - 38 206 Name of Law: Equal Pay Act of 1963
   PL: Pub.L. 110 - 233 201 Name of Law: Genetic Nondiscrimination Act of 2008
   PL: Pub.L. 107 - 174 301 Name of Law: Notification and Federal Employee Antidiscrimination and Retaliation Act of 2002

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:
	90 FR 42624	09/03/2025
30-day Notice:	Federal Register Citation:	Citation Date:
	91 FR 12451	03/13/2026
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 646, "Formal Discrimination Complaint"	NRC Form 646

ICR Summary of Burden

	Total Request	Previously Approved
Annual Number of Responses	30	30
Annual Time Burden (Hours)	30	30
Annual Cost Burden (Dollars)	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:

Annual Cost to Federal Government: $3,170

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. Yes

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. Yes

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: Larniece McKoy-Moore 301 415-1942

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