United States Nuclear Regulatory Commission - Protecting People and the Environment

NRC Forms

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NOTE REGARDING FORM EXPIRATION DATES:  It is the NRC’s policy to submit all forms to the Office of Management and Budget (OMB) for review prior to their expiration dates.  If OMB does not complete its review of a form prior to the form’s expiration date, the expiration date is automatically extended.  Forms currently under review by OMB may display an expiration date that has passed.  Once OMB review is complete and a new expiration date is assigned, the date will be updated.  For a list of forms currently under review at OMB, go to the OMB's Information Collection Review page and select “Nuclear Regulatory Commission” in the box titled “Currently Under Review.”  You may send an email to Forms.Resource@nrc.gov to verify that a form is still in the renewal process.

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NRC Forms

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Go to
NRC Form
Go to
Info Sheet
Title of Form
3 Form Information Icon Notice to Employees
3A Form Information Icon Aviso a los Empleados
4 Form Information Icon Cumulative Occupational Dose History
5 Form Information Icon Occupational Dose Record for a Monitoring Period
7 Form Information Icon Application for NRC Export or Import License, Amendment, Renewal, or Consent Request(s)
64 Form Information Icon Travel Voucher
136 Form Information Icon Security Termination Statement
176 Form Information Icon A. Security Acknowledgment
B. Special Nuclear Material Access Authorization Acknowledgment
189 Form Information Icon DOE Laboratory Project and Cost Proposal for NRC Work
212 Form Information Icon Qualifications Investigation Professional, Technical, and Administrative Positions
237 Form Information Icon Request for Access Authorization
241 Form Information Icon Report of Proposed Activities in Non-Agreement States, Areas of Exclusive Federal Jurisdiction, or Offshore Waters
244 Form Information Icon Registration Certificate - Use of Depleted Uranium under General License
277 Form Information Icon Request for Visit
313 Form Information Icon Application for Materials License
313A(amp) Form Information Icon Authorized Medical Physicist Training and Experience And Preceptor Attestation
313A(anp) Form Information Icon Authorized Nuclear Pharmacist Training and Experience and Preceptor Attestation
313A(aud) Form Information Icon Authorized User Training and Experience And Preceptor Attestation
313A(aus) Form Information Icon Authorized User Training and Experience And Preceptor Attestation
313A(aut) Form Information Icon Authorized User Training and Experience And Preceptor Attestation
313A(rso) Form Information Icon Radiation Safety Officer Training and Experience And Preceptor Attestation
314 Form Information Icon Certificate of Disposition of Materials
327 Form Information Icon Special Nuclear Material (SNM) and Source Material (SM) Physical Inventory Summary Report
335 Form Information Icon Bibliographic Data Sheet
354 Form Information Icon Data Report on Spouse
356 Form Information Icon

U. S. Nuclear Regulatory Commission Senior Executive Service (SES) Candidate Development Program (CDP) Management Evaluation Form

361 Form Information Icon Reactor Plant Event Notification Worksheet
361A Form Information Icon Fuel Cycle and Materials Event Notification Worksheet
361C Form Information Icon Gaseous Diffusion Plant Event Notification Worksheet
366 Form Information Icon Licensee Event Report (LER)
366A Form Information Icon Licensee Event Report (LER) [Continuation]
366B Form Information Icon Licensee Event Report Failure [Continuation]
390A Form Information Icon Release to Publish Unclassified NRC Contractor Speeches, Papers, and Journal Articles
396 Form Information Icon

Certification of Medical Examination by Facility Licensee (with instructions)

396 Form Information Icon

Certification of Medical Examination by Facility Licensee (without instructions)

398 Form Information Icon Personal Qualification Statement - Licensee
426 Form Information Icon Authorization to Publish a Manuscript in the NUREG Series
445 Form Information Icon Request for Approval of Official Foreign Travel
450 Form Information Icon General Assignment
483 Form Information Icon Registration Certificate - in vitro Testing with Byproduct Material Under General License
526 Form Information Icon Certification of Small Entity Status for the Purposes of Annual Fees Imposed under 10 CFR Part 171 (Effective August 22, 2012)
531 Form Information Icon Request for Taxpayer Identification Number
536 Form Information Icon Operator Licensing Examination Data
540 Form Information Icon Uniform Low-Level Radioactive Waste Manifest – Shipping Paper
540A Form Information Icon Uniform Low-Level Radioactive Waste Manifest – Shipping Paper  (continuation)
541 Form Information Icon Uniform Low-Level Radioactive Waste Manifest – Container and Waste Description
541A Form Information Icon Uniform Low-Level Radioactive Waste Manifest – Container and Waste Description (continuation)
542 Form Information Icon Uniform Low-Level Radioactive Waste Manifest – Manifest Index and Regional Compact Tabulation
542A Form Information Icon Uniform Low-Level Radioactive Waste Manifest – Manifest Index and Regional Compact Tabulation (continuation)
552A Form Information Icon Status Report Review
554B Form Information Icon Independent Government Cost Estimate (IGCE) for Interagency Agreements
555A Form Information Icon Summary of Negotiations
Interagency Agreement
556A Form Information Icon Fiscal Year Advance Procurement Plan Interagency Agreement
558A Form Information Icon Summary of Proposal Evaluation
Interagency Agreement
559A Form Information Icon NRC/Interagency Project Closeout
590 Form Information Icon Application/Permit for Use of the Two White Flint North (TWFN) Auditorium
629 Form Information Icon Authorization for Payment by Credit Card
653 Form Information Icon Transfers of Industrial Devices Report
662 Form Information Icon Award of Interagency Agreement
664 Form Information Icon General Licensee Registration
667 Form Information Icon Servicing Agency Project and Cost Proposal for NRC Work
740M Form Information Icon Concise Note
741 Form Information Icon Nuclear Material Transaction Report
742 Form Information Icon Material Status Report
742C Form Information Icon Physical Inventory Listing
781 Form Information Icon SBCR Compliance Review Part A, Part B, and Part C
782 Form Information Icon Complaint Form
790 Form Information Icon Classification Record
830 Form Information Icon Report of Import
830A Form Information Icon Report of Import Continuation Sheet
831 Form Information Icon Report of Export
831A Form Information Icon Report of Export Continuation Sheet
833 Form Information Icon Form to Propose a Generic Issue (GI)
835 Form Information Icon U. S. Nuclear Regulatory Commission Office of the Inspector General FAR Contractor Reporting Form

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IAEA Forms

Go to
IAEA Form
Go to Info Sheet Title of Form
IAEA - N71 Form Information Icon IAEA Design Information Questionnaire
All Facilities
IAEA - N72 Form Information Icon IAEA Design Information Questionnaire
Research and Power Reactors
IAEA - N73 Form Information Icon IAEA Design Information Questionnaire
Conversion and/or Fuel Fabrication Plants
IAEA - N74 Form Information Icon IAEA Design Information Questionnaire
Reprocessing Plants
IAEA - N75 Form Information Icon IAEA Design Information Questionnaire
Isotopic Enrichment Plants
IAEA - N91 Form Information Icon IAEA Design Information Questionnaire
Information in Respect of Nuclear Material Outside Facilities
IAEA - N92 Form Information Icon IAEA Design Information Questionnaire
Research and Development Facilities
(Locations of Nuclear Material in Amounts Greater Than One Effective Kilogram)
IAEA - N93 Form Information Icon IAEA Design Information Questionnaire
Critical (Sub-Critical) Facilities
IAEA - N94 Form Information Icon IAEA Design Information Questionnaire
Separate Storage Installations

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Page Last Reviewed/Updated Friday, August 30, 2013