NRC Forms
These forms are in fillable Portable Document Format (PDF), with the exception of NRC form 664. These forms require Adobe Reader. You can view or print the blank form, or you can complete the form and print it. The Reader can be downloaded for free by following the directions on our Plugins and Viewers page.
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NRC Forms
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Go to NRC Form |
Go to Info Sheet |
Title of Form |
---|---|---|
3 | Notice to Employees | |
3A | Aviso a los Empleados | |
4 | Cumulative Occupational Dose History | |
5 | Occupational Dose Record for a Monitoring Period | |
7 | Application for NRC Export/Import License, Amendment, or Renewal | |
64 | Travel Voucher | |
136 | Security Termination Statement | |
176 | A. Security Acknowledgment B. Special Nuclear Material Access Authorization Acknowledgment |
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189 | DOE Laboratory Project and Cost Proposal for NRC Work | |
212 | Qualifications Investigation Professional, Technical, and Administrative Positions | |
237 | Request for Access Authorization | |
241 | Report of Proposed Activities in Non-Agreement States, Areas of Exclusive Federal Jurisdiction, or Offshore Waters | |
244 | Registration Certificate - Use of Depleted Uranium under General License | |
277 | Request for Visit | |
313 | Application for Materials License | |
313A(amp) | Authorized Medical Physicist Training and Experience And Preceptor Attestation | |
313A(anp) | Authorized Nuclear Pharmacist Training and Experience and Preceptor Attestation | |
313A(aud) | Authorized User Training and Experience And Preceptor Attestation | |
313A(aus) | Authorized User Training and Experience And Preceptor Attestation |
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313A(aut) | Authorized User Training and Experience And Preceptor Attestation | |
313A(rso) | Radiation Safety Officer Training and Experience And Preceptor Attestation | |
314 | Certificate of Disposition of Materials | |
327 | Special Nuclear Material (SNM) and Source Material (SM) Physical Inventory Summary Report | |
335 | Bibliographic Data Sheet | |
354 | Data Report on Spouse | |
361 | Reactor Plant Event Notification Worksheet | |
361A | Fuel Cycle and Materials Event Notification Worksheet | |
361C | Gaseous Diffusion Plant Event Notification Worksheet | |
366 | Licensee Event Report (LER) | |
366A | Licensee Event Report (LER) [Continuation] | |
366B | Licensee Event Report Failure [Continuation] | |
390A | Release to Publish Unclassified NRC Contractor Speeches, Papers, and Journal Articles | |
396 | Certification of Medical Examination by Facility Licensee (with instructions) |
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396 | Certification of Medical Examination by Facility Licensee (without instructions) |
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398 | Personal Qualification Statement - Licensee | |
426 | Authorization to Publish a Manuscript in the NUREG Series | |
445 | Request for Approval of Official Foreign Travel | |
450 | General Assignment | |
483 | Registration Certificate - in vitro Testing with Byproduct Material Under General License | |
526 | Certification of Small Entity Status for the Purposes of Annual Fees Imposed under 10 CFR Part 171 (Effective August 22, 2012) | |
531 | Request for Taxpayer Identification Number | |
536 | Operator Licensing Examination Data | |
540 | Low Level Waste Manifest Shipping Paper |
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540A | Low Level Waste Manifest Shipping Paper (Continuation) |
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541 | Low Level Waste Manifest Container and Waste Description |
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541A | Low Level Waste Manifest Container and Waste Description (Continuation) |
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542 | Low Level Waste Manifest Index and Regional Compact Tabulation |
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542A | Low Level Waste Manifest Index and Regional Compact Tabulation (Continuation) |
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552A | Status Report Review | |
554B | Independent Government Cost Estimate (IGCE) for Interagency Agreements | |
555A | Summary of Negotiations Interagency Agreement |
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556A | Fiscal Year Advance Procurement Plan Interagency Agreement | |
558A | Summary of Proposal Evaluation Interagency Agreement |
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559A | NRC/Interagency Project Closeout | |
590 | Application/Permit for Use of the Two White Flint North (TWFN) Auditorium | |
629 | Authorization for Payment by Credit Card | |
653 | Transfers of Industrial Devices Report | |
662 | Award of Interagency Agreement | |
664 | General Licensee Registration | |
667 | Servicing Agency Project and Cost Proposal for NRC Work | |
740M | Concise Note | |
741 | Nuclear Material Transaction Report | |
742 | Material Status Report | |
742C | Physical Inventory Listing | |
790 | Classification Record | |
830 | Report of Import | |
830A | Report of Import Continuation Sheet | |
831 | Report of Export | |
831A | Report of Export Continuation Sheet |
IAEA Forms
Go to IAEA Form |
Go to Info Sheet | Title of Form |
---|---|---|
IAEA - N71 | IAEA Design Information Questionnaire All Facilities |
|
IAEA - N72 | IAEA Design Information Questionnaire Research and Power Reactors |
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IAEA - N73 | IAEA Design Information Questionnaire Conversion and/or Fuel Fabrication Plants |
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IAEA - N74 | IAEA Design Information Questionnaire Reprocessing Plants |
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IAEA - N75 | IAEA Design Information Questionnaire Isotopic Enrichment Plants |
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IAEA - N91 | IAEA Design Information Questionnaire Information in Respect of Nuclear Material Outside Facilities |
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IAEA - N92 | IAEA Design Information Questionnaire Research and Development Facilities (Locations of Nuclear Material in Amounts Greater Than One Effective Kilogram) |
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IAEA - N93 | IAEA Design Information Questionnaire Critical (Sub-Critical) Facilities |
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IAEA - N94 | IAEA Design Information Questionnaire Separate Storage Installations |
Standard and Optional Forms
Go to SF Form |
Title of Form |
---|---|
SF312 | Classified Information Nondisclosure Agreement |
Page Last Reviewed/Updated Wednesday, August 22, 2012