Information Collection

Job Applicants

IC 249959 under ICR 202110-1557-003 · OMB 1557-0352.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1557-0352 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Job Applicants	Form
Medical Exception to COVID Vaccination Requirement Medical Exception to COVID Vaccination Requirement OCC Fillable Form Oct 2021.pdf	Form
Medical Exception to COVID Vaccination Requirement Medical Exception to COVID Vaccination Requirement OCC Fillable Form Oct 2021.pdf	Form

IC Title:

Job Applicants

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	N/A	Medical Exception to COVID Vaccination Requirement	Medical Exception to COVID Vaccination Requirement OCC Fillable Form Oct 2021.pdf		Yes	Yes	Fillable Fileable Signable

Line of Business: Economic Development

Subfunction: Financial Sector Oversight

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 2

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	2	2
Annual IC Time Burden (Hours)	1	1
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

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