Certificate of Medical Examination

OF 178 Certificate of Medical Examination

OMB: 3206-0250

IC ID: 187036

Documents and Forms
Document Name
Document Type
Form and Instruction
Form and Instruction
Information Collection (IC) Details

View Information Collection (IC)

Certificate of Medical Examination
 
No Modified
 
Voluntary
 
5 CFR 339

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction OF 178 Certificate of Medical Examination OF 178.pdf Yes No Fillable Fileable

Workforce Management Training and Employment

OPM/GOVT-10, Employee Medical File System Records  71 FR 35360

45,000 0
   
Federal Government
 
   0 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 45,000 0 0 0 0 45,000
Annual IC Time Burden (Hours) 135,000 0 0 0 0 135,000
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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