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NRC Form 354 - Data Report on Spouse

Form Number: NRC Form 354 PDF Icon
Form Title: Data Report on Spouse
Current Edition: 09-2019
Authority Directive or Regulation: N/A
Form Status: Approved by OMB: 3150-0026, Expires: 05/31/2021
Special Instructions:


Instructions and additional information pertinent to the completion of the form are on Page 2 of the form.

Completed NRC Form 354s shall be submitted in the following manner:

  • By mail addressed to: ATTN: Document Control Desk, Director, Division of Facilities and Security, Office of Administration, U.S. Nuclear Regulatory Commission, Washington, DC 20555–0001;
  • By hand delivery to the NRC's offices at 11555 Rockville Pike, Rockville, Maryland; or

For Questions Call:  Emily Robbins at (301) 415-7000 or Emily.Robbins@nrc.gov

Page Last Reviewed/Updated Thursday, October 03, 2019