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DD Form 3176, "REQUEST FOR A MEDICAL EXEMPTION OR DELAY TO THE COVID-19 VACCINATION REQUIREMENT"

ICR 202111-0704-010 · OMB 0704-0619 · Object 116632600.

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application/octet-stream
DD Form 3176, "REQUEST FOR A MEDICAL EXEMPTION OR DELAY TO THE COVID-19 VACCINATION REQUIREMENT"
DoD Component
2021-11-23
2021-10-18
complete