Vaccination Certification Requirements for Prospective Employees with Federal Job Offers

Submissions Related to the COVID-19 Vaccination Requirement

Documents and Forms

Document Name Document Type
Form Not Applicable Vaccination Certification Requirements for Prospective Employees with Federal Job Offers Form and Instruction
Medical Exception Request-Letter-11_29_2021.pdf Other-Emergency Request Letter
Medical Exception Request-Letter-11_29_2021.pdf Other-Emergency Request Letter
Not Applicable Letter for Final Job Offer Final Offer Letter with Vaccination Language.pdf Form and Instruction
Not Applicable Letter for Final Job Offer Final Offer Letter with Vaccination Language.pdf Form and Instruction

Information Collection (IC) Details

IC Title:	Vaccination Certification Requirements for Prospective Employees with Federal Job Offers	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	Not Applicable	Letter for Final Job Offer	Final Offer Letter with Vaccination Language.pdf		Yes	Yes	Printable Only
Other-Emergency Request Letter			Medical Exception Request-Letter-11_29_2021.pdf		Yes	Yes	Fillable Printable

Line of Business: Economic Development

Subfunction: Business and Industry Development

Privacy Act System of Records
Title: FTC-II-4	FR Citation: 84 FR 16493

Number of Respondents: 50	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to New Statute	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	50	50	0
Annual IC Time Burden (Hours)	9	0	9
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

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.