Supporting Statement A Question #12 Detailed Response

OMB 1910-5122: Human Reliability Program -- Detail for Item 12 (Supporting Statement)
No.	Collection Title	FY 2012 Estimated Annual Respondents	FY 2012 Estimated Annual Responses	Approximate Time to Complete Each Response	FY 2012 Estimated Annual Burden Hours	FY 2016 Estimated Annual Respondents	FY 2016 Estimated Annual Responses	% Submitted Electronically	Approximate Time (mins) to Complete Each Response	FY 2016 Estimated Annual Burden Hours	Changes in Estimated Annual Hours (K-F)	Main Factors for Changes
1	DOE F 470.3, Human Reliability Program (HRP) Certification	9,455	9,472	10 minutes	1,479	9,455	9,472	0.0%	10	1,579	100	No Change made in number of responses or approximate time for each response. Math errors corrected from previous submission.
2	DOE F 470.4, Acknowledgement and Agreement to Participate in the Human Reliability Program (HRP)	9,094	9,105	2 minutes	455	9,094	9,105	0.0%	2	304	(151)	No Change made in number of responses or approximate time for each response. Math errors corrected from previous submission.
3	DOE 470.5, Authorization and consent to release Human Reliability Program (HRP) Records in Connection with the HRP	9,094	9,105	2 minutes	306	9,094	9,105	0.0%	2	304	(2)	No Change made in number of responses or approximate time for each response. Math errors corrected from previous submission.
4	DOE F 470.6, Refusal of Consent	0	0	6 minutes	0	0	0	0.0%	6	0	0	No Change
5	DOE F 470.7, Human Reliability Program (HRP) Alcohol Testing Form	16,317	16,317	6 minutes	1,633	16,317	16,317	0.0%	6	1,632	(1)	No Change made in number of responses or approximate time for each response. Math errors corrected from previous submission.
	Totals	43,960	43,999		3,873	43,960	43,999			3,819	(54)	No Change made in number of responses or approximate time for each response. Math errors corrected from previous submission.