NRC Form 354 - Data Report on Spouse

Form Number: NRC Form 354
Form Title: Data Report on Spouse
Current Edition: 07-01-2024
Authority Directive or Regulation: N/A
Form Status: Approved by OMB: 3150-0026, Expires: 07/31/2024
Special Instructions:

Instructions

This form will be completed by persons who marry or cohabitate after the time they submit the Standard Form 86 (SF-86), "Questionnaire for National Security Positions," or marries or cohabitates after having been granted an access authorization, or employment clearance in connection with the U.S. Nuclear Regulatory Commission (NRC) access authorization (security clearance).This form will be submitted to the Federal Bureau of Investigations for the purpose of conducting name checks on the spouse/cohabitant and spouse's parents.

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 Monday, July 01, 2024