Eib 21-03 Request For A Medical Exception To The Covid-19 Vaccination Requirement

REQUEST FOR A MEDICAL EXCEPTION TO THE COVID-19 VACCINATION REQUIREMENT

OMB: 3048-0058

IC ID: 250594

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EIB 21-03 REQUEST FOR A MEDICAL EXCEPTION TO THE COVID-19 VACCINATION REQUIREMENT EIB 21-03
 
No New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction EIB 21-03 Request for a Medical Exception to COVID-19 Vaccination EIB 21-03 Request for a Medical Exception to COVID-19 Vaccination Form_v3 - fillable.pdf https://www.exim.gov/sites/default/files/pub/pending/eib21-03.pdf Yes Yes Fillable Fileable

Economic Development Business and Industry Development

EXIM – 21-03: Reasonable Accommodation Records   86 FR 63377

12 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 12 0 12 0 0 0
Annual IC Time Burden (Hours) 24 0 24 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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