NRC Form 176 - A. Security Acknowledgment, B. Special Nuclear Material Access Authorization Acknowledgment, C. Security Debriefing Acknowledgement

Form Number: NRC Form 176
Form Title: A. Security Acknowledgment
B. Special Nuclear Material Access Authorization Acknowledgment
C. Security Debriefing Acknowledgement
Current Edition: 11-07-2022
Authority Directive or Regulation: 10 CFR 11, NRC Management Directive 12.3
Form Status: Approved by OMB: 3150-0239, Expires: 11-30-2025
Special Instructions: N/A

Page Last Reviewed/Updated Tuesday, November 08, 2022