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NRC Form 396 2021-2025 free printable template

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PERSONALLY IDENTIFIABLE INFORMATION WITHHOLD UNDER 10 CFR 2.390 U.S. NUCLEAR REGULATORY COMMISSION NRC FORM 396 (092021) 10 CFR 55.21, 55.23, 55.25, 55.27, 55.31 55.33, 55.53, 55.57.CERTIFICATION
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How to fill out NRC Form 396

01
Obtain NRC Form 396 from the NRC website or your local NRC office.
02
Read the instructions carefully to understand the requirements.
03
Fill out Section 1 with your personal information, including name, address, and contact details.
04
Complete Section 2 by providing details about the facility you are associated with.
05
In Section 3, describe the purpose of the form and the specific request you are making.
06
Attach any necessary supporting documents as required by the instructions.
07
Review the filled form for accuracy and completeness.
08
Sign and date the form in the designated area.
09
Submit the form either online or by mailing it to the appropriate NRC office.

Who needs NRC Form 396?

01
Individuals or organizations that need to obtain a specific license or amendment under the NRC regulations.
02
Facilities that handle radioactive materials and require authorization.
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NRC Form 396 is a document used by the Nuclear Regulatory Commission to be filled out by individuals or organizations that are seeking authorization to use radioactive materials.
Individuals or organizations that wish to become authorized users of radioactive materials under the regulations of the Nuclear Regulatory Commission must file NRC Form 396.
To fill out NRC Form 396, applicants must provide details about their qualifications, experience with radioactive materials, and any relevant educational background as required by the form.
The purpose of NRC Form 396 is to ensure that individuals or organizations applying for authorization to use radioactive materials meet the necessary training and experience requirements set by the NRC.
NRC Form 396 requires reporting of the applicant's name, qualifications, work history, certification, training in radiation safety, and any previous experience with radioactive materials.
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