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:	12-01-2025
Authority Directive or Regulation:	10 CFR 11, NRC Management Directive 12.3
Form Status:	Approved by OMB: 3150-0239, Expires: 12/31/2025
Special Instructions:	N/A

Page Last Reviewed/Updated Monday, December 08, 2025