The form will be used by NRC contractors and visitors to document their vaccination status. They will retain the completed form to show as requested for entry.
EO: EO 13991 Name/Subject of EO: Protecting the Federal Workforce and Requiring Mask Wearing
$600
David Cullison 301 415-2084 david.cullison@nrc.gov
IC Title
Status
Responses
Hours
Dollars
Document Type
Form No.
Form Name
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
250
0
0
250
0
0
Annual Time Burden (Hours)
8
0
0
8
0
0
Annual Cost Burden (Dollars)
203
0
0
203
0
0
Yes
Miscellaneous Actions
No
This is a new collection required to comply with EO 13991