NRC Form 781 SBCR Complaint Review

NRC FORM 781
(MM-DD-YYYY)

U.S. NUCLEAR REGULATORY COMMISSION

SBCR COMPLIANCE REVIEW
PART A

APPROVED BY OMB: NO. 3150-0053

EXPIRES: (MM/DD/YYYY)

Estimated burden per response to comply with this mandatory collection request: 1.5 hours. This information is
required by NRC to process payments to contractors. Send comments regarding burden estimate to the FOIA,
Library, and Information Collections Branch (T-6 A10), U.S. Nuclear Regulatory Commission, Washington, DC
20555-0001, or by email to Infocollects.Resource@nrc.gov, and the OMB reviewer at: OMB Office of Information
and Regulatory Affairs, (3150-0053), Attn: Desk Officer for the Nuclear Regulatory Commission, 725 17th Street
NW, Washington, DC 20503. The NRC may not conduct or sponsor, and a person is not required to respond to, a
collection of information unless the document requesting or requiring the collection displays a currently valid OMB
control number.

FOR SBCR USE ONLY

Date Compliance Review Inquiry Completed

Applicant Name

Application For

PLEASE RESPOND TO ALL INQUIRIES & SUBMIT APPLICABLE PROGRAM INFORMATION & DOCUMENTS TO:
EEOPrograms.Resource@nrc.gov, OR FAX: (301) 415-5953
ATTENTION: EXTERNAL CIVIL RIGHTS PROGRAM
CONTACT NUMBER: (301) 415-7380
1. Program/Contract Services: Identify the manner in which services are or will be provided, and data/information necessary for determining whether any
persons are or will be denied such services on the basis of prohibited discrimination.

2. Program Contract Population Served: Identify the geographic location(s) where program activities/services will be provided.
Headquarters (Washington, DC Metropolitan areas)

Region IV Arlington, Texas or surrounding areas

Region I King of Prussia, Pennsylvania or surrounding areas

Other (Specify)

Region II Atlanta, Georgia or surrounding areas
Region III Naperville, Illinois or surrounding areas
3. Collection of EO Data: Recipients are required to track and maintain EO data regarding the population eligible to be served and actual program
participants (i.e., race, color, national origin, sex). How does/will the recipient program collect EO data?

4. Limited English Proficiency: Provide information/data regarding covered employment, including use or planned use of bilingual public-contact
employees serving beneficiaries of the program where necessary to permit effective participation by beneficiaries unable to speak or understand English.

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U.S. NUCLEAR REGULATORY COMMISSION

SBCR COMPLIANCE REVIEW PART A (Continued)
5. Facilities and/or Locations: Identify the location(s) of existing or proposed facilities connected with the program/services, and related information adequate
for determining whether the location has or will have the effect of unnecessarily denying access to any persons on the basis of prohibited discrimination.

6. Organizational Membership: Identify the present or proposed membership, by race, color, sex, and national origin, in any planning or advisory body which
is an integral part of the program/service (e.g., 3 Caucasian males, 2 African American females, etc. Do NOT identify specific individuals in the group by
name).

7. Changes in Location: If applicable, identify where relocation is involved, the requirements and steps used or proposed to guard against unnecessary
impact on persons in the protected classes identified in Question number 3.

NRC FORM 781 (MM-DD-YYYY)

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NRC FORM 781

U.S. NUCLEAR REGULATORY COMMISSION

(MM-DD-YYYY)

SBCR COMPLIANCE REVIEW PART B
In Agreement:
1. Promptly notify NRC/SBCR upon its request of any lawsuit filed against the applicant or recipient alleging
discrimination on the basis of race, sex, color, national origin, disability, religion, age, status as a parent,
or other bases protected by statute.

Yes
No

Yes

2. Promptly notify NRC/SBCR upon any complaints filed against the recipient alleging discrimination.

No

3. Submit compliance reports upon the agency's request to the Nuclear Regulatory Commission Office of
Small Business and Civil Rights (SBCR). Submit an annual EO compliance report to SBCR no later
than December 31 of each calendar year.
4. Provide comprehensive civil rights training for staff, and periodically retrain staff to establish and update
their knowledge of EO civil rights statutes and emerging issues.

Yes
No

Yes
No

5. Check whether there are any pending applications to other Federal Agencies for assistance, and of Federal assistance being
provided at the time of the application or requested report.
No other applications for Federal assistance are pending
Other applications for Federal assistance are pending
Federal assistance is being provided at the time of the application/requested report
*If applications for assistance are pending, or Federal assistance is being provided,
please provide a brief description, and forward NRC/SBCR all related documentation.

6. Check whether any civil rights compliance reviews have been conducted during the two-year period before the application,
and forward information concerning the agency or organization performing the review; and any periodic statements regarding
such reviews.
No civil rights compliance review have been conducted
One or more civil rights compliance review have been conducted
No findings of a noncompliance with a relevant civil rights requirement
*If civil rights compliance reviews have been conducted, or there has been a finding of a
noncompliance with a civil rights requirement, please provide a brief description, and
forward NRC/SBCR all related documentation.

7. Please type in your full name, title and date below indicating your agreement to compile and maintain the records required,
pursuant to NRC's guidelines, and Civil Rights directives.
Typed or Printed Name and Title

Date (MM/DD/YYYY)

Signature

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U.S. NUCLEAR REGULATORY COMMISSION

(MM-DD-YYYY)

SBCR COMPLIANCE REVIEW PART C
ADDITIONAL TITLE IX INFORMATION
Please check the box that applies to your organization:
The recipient organization provides some type(s) of education programs or activities.
The recipient organization does not provide any education programs or activities.
This Section contains additional data collections imposed under Title IX of the Educational Amendments of 1972 and the Nuclear Regulatory
Commission Title IX implementing Regulations (NRC) set forth in Title 10 of the Code of Federal Regulations, Part 5. Except as provided in
§§5.205 through 5.235(a), of NRC's Title IX regulations, these requirements apply to every recipient and to each education program or activity
operated by a recipient that receives Federal financial assistance.
Please check yes or no in the appropriate boxes to indicate whether your organization is in compliance with the following Title IX requirements:

Required Title IX Assurances to Fulfill Requirements Under §5.135 and Title IX:
Yes
No

Yes
No
Yes
No

Provides assurance that all of the recipient's education programs or activities will be operated in compliance with the
nondiscrimination mandates of Title IX and NRC's implementing regulations (e.g., Admissions and Recruitment. See
§§5.300 through 5.310; Education Programs or Activities. See §§5.400 through 5.455; and Employment in Education Programs
or Activities. See §§5.500 through 5.550).
Provides assurance that the recipient will take whatever remedial action is necessary in accordance with §5.110(a) to eliminate
existing discrimination on the basis of sex or to eliminate the effects of past discrimination whether occurring prior to or
subsequent to the assurance given.
Provides assurance that the assurances in this section will be required of the applicant or recipient sub-grantees, contractors,
subcontractors, transferees, or successors in interest.

Please check the box that applies to your organization:
Designation of Title IX Coordinator, Notification to Students and Employees and Adoption of Grievance Procedures to
Fulfill Requirements Under §5.135 and Title IX:
Yes
No
Yes
No
Yes
No

Has designated at least one responsible employee to coordinate Title IX compliance efforts and carry out the recipient's
responsibilities under Title IX and NRC's implementing regulations, including coordinating any investigations of complaints or
noncompliance with Title IX regulations.
Has and will continue to provide notification to all of the recipient's students and employees of the name, office address, and
telephone number of the employee or employees designated to coordinate the recipient's Title IX efforts.
Has adopted and published an internal grievance procedure to determine whether a particular act, policy, or practice of the
recipient complies with Title IX regulations; and that promptly and equitably resolves complaints alleging discrimination on the
basis of sex in education programs or activities.

Dissemination of Title IX Policy to Fulfill Requirements Under §5.140 and Title IX:
Yes
No

Yes
No
Yes
No
Yes
No
Yes
No

Has taken specific steps to regularly and consistently notify the public - i.e., participants, employees, applicants, etc. that the
recipient does not discriminate on the basis of sex in the operation of its education programs and activities; Title IX and Title IX
regulations also apply to employment in and admission to the recipient's education programs and activities; and inquiries
regarding Title IX and Title IX regulations may be referred to the recipient's designated Title IX Coordinator, or Federal funding
agency/official (i.e., Nuclear Regulatory Commission Office of Small Business and Civil Rights).
Prominently publishes a statement of the Title IX policy described in this section in each announcement, bulletin, catalog, or
application form that the recipient makes available to the public or that is used in connection with any recruitment of students or
employees.
Ensures that the notification is widely disseminated and easily understood.
Ensures that the recipient does not use or distribute a publication that suggests by its text or illustration that it treats applicants,
students or employees differently on the basis of sex-except as permitted under the Title IX regulations.
Distributes the recipient's Title IX policies without discrimination on the basis of sex, informs each of its admission and
employment recruitment representatives of the Title IX nondiscrimination policies, and requires that the representatives adhere
to the policies.

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NRC FORM 781

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U.S. NUCLEAR REGULATORY COMMISSION

SBCR COMPLIANCE REVIEW PART D

This Section contains additional data collections imposed under Anti-Harassment Provisions Under the “Creating
Helpful Incentives to Produce Semiconductors” (CHIPS) and Science Act of 2022 [div. A of Pub. L. 117-167] Section
10536 of the CHIPS and Science Act requires higher education or nonprofit institutions applying for Federal grants and those
who receive Federal research grants to comply with the CHIPS and Science Act's anti-harassment provisions, which prohibit
sex-based and sexual harassment of all research personnel. The CHIPS Act requires applicants and recipients to demonstrate a
commitment to preventing and handling sex-based and sexual harassment, and when it does occur reduce its impact.
Please check yes or no in the appropriate boxes to indicate whether your organization is in compliance with the following CHIPS
and Science Act of 2022 requirements:
1. As a condition of award of NRC Federal Financial Assistance, the awardee institution is required to provide
information to all award personnel about NRC's discrimination/harassment policies and complaint reporting
procedures at the onset of the award period; and to post the information in prominent locations to inform staff,
beneficiaries and potential beneficiaries in each announcement, bulletin, catalog, or application form that the
recipient makes available to the public including on its website or other virtual places.
2. A poster or brochure containing information provided in the notice identified under number 1 above should also
be posted/provided in physical areas (e.g., research lab, principal investigator (PI) office, graduate student and
post doctorate office areas, restroom stalls) and virtual places frequently used by the personnel participating in
the award or activity (e.g., PI's research lab, website).
3. Establish robust policies for preventing, responding to, and addressing sex-based misconduct and sexual
harassment in STEM environments involving federal funded research, programs, projects, or awards.
4. Establish an electronic reporting system or web platform, for individuals to share information about instances of
harassment involving funded programs and personnel that does not necessitate the filing of a complaint and
allows individuals the option to anonymously share information.
5. Establish instructions for reporting/filing a complaint that clearly describe the investigative process. Details
should include at a minimum: how a complaint is filed, who receives the complaint at the awardee institution,
how, where, and for how long the information is stored; potential time lines and notification, investigation,
resolution, and monitoring; the role of the award institution in the investigative process; potential options for
actions for possible report outcomes; retaliation protections; and any supports or policies that exist to minimize
educational, training, and career disruptions to the complainant, or to support reintegration of the complainant at
the awardee institution. These details should be summarized on the awardee institution's web pages with
instructions for reporting, and additional details provided on a separate page/document easily accessible by a
complainant. Also, include information about other venues in which complainants can file a complaint such as,
the NRC.
6. Promptly provide institutional reports notifying the NRC of allegations of sex-based misconduct and sexual
harassment in STEM Environments involving federal research awards, notification of findings, and
determinations of harassment involving award personnel, and timely investigate all complaints filed.
7. Provide initial and refresher evidence-based training programs and resources for principal investigators, faculty,
senior leadership, and other staff involved in federal research awards including FAQ documents, best practices,
recordings of webinars and workshops, blogs, podcasts, videos, and other materials and resources.
8. If federal assistance is used to fund conferences, meetings, workshops, off-campus or field research sites,
technology-facilitated interactions, and other convenings, the awardee institution is required to develop sitespecific policies, codes of conduct for creating physically safe and psychologically safe environments, reporting
procedures, clear protocols for project personnel to take if they fear being at risk of harassment, and clear
protocols for immediately addressing harassment and other kinds of misconduct before it rises to the level of
illegal harassment, including through online and technology-facilitated means.
NRC FORM 781 (MM-DD-YYYY)

Yes
No

Yes
No

Yes
No
Yes
No
Yes
No

Yes
No

Yes
No

Yes
No

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NRC FORM 781
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SBCR COMPLIANCE REVIEW PART D (Continued)

9. Conduct data collections and evaluations in regular intervals to determine which policies, procedures, and
actions have been effective at changing institutional report rates and/or reduce incidence rates of sex-based and
sexual harassment involving award personnel to inform evaluation of institutional compliance and monitoring
efforts.
10. Take actions against perpetrators of sex-based misconduct and sexual harassment that are appropriate and
proportional to the behavior found to have occurred.

NRC FORM 781 (MM-DD-YYYY)

Submit by Email

Yes
No
Yes
No

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