COVID Medical and Religious Reasonable Accommodation Exception Forms

Forms and Documents

Document Name	Status
Form NSF Religious Reasonable Accommodation Request Form and Instruction	New
Form NSF NSF Request for a Medical Exception to the COVID-19 Vaccination Requirement Form and Instruction	New
Supporting Statement -- NSF Medical and Religious Reasonable Accommodation Forms -- FINALv2 -- 2021-11-10.pdf Supporting Statement A	2021-11-10
NSF Emergency PRA Clearance Request -- FINAL SIGNED -- 2021-11-10.pdf Supplementary Document	2021-11-10

IC Document Collections

IC ID	Document Title	Status
250292	Religious Reasonable Accommodation Request Form and Instruction	New
250291	NSF Request for a Medical Exception to the COVID-19 Vaccination Requirement Form and Instruction	New

ICR Details

OMB Control No:	ICR Reference No: 202111-3145-003
Status: Received in OIRA	Previous ICR Reference No:
Agency/Subagency: NSF	Agency Tracking No:
Title: COVID Medical and Religious Reasonable Accommodation Exception Forms
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Emergency	Approval Requested By: 11/20/2021
Date Submitted to OIRA: 11/10/2021

	Requested	Previously Approved
Expiration Date	6 Months From Approved
Responses	200	0
Time Burden (Hours)	300	0
Cost Burden (Dollars)	23,536	0

---

Abstract: Pursuant to Executive Order 14043 (Sept. 9, 2021) and guidance issued by the Centers for Disease Control and Prevention (CDC) and the Safer Federal Workforce Task Force (SFWTF), all Federal employees, as defined by 5 U.S.C. 2105, must be vaccinated against COVID-19, with exceptions only as required by law, no later than November 22, 2021. This requirement extends to other NSF staff (e.g., Intergovernmental Personnel Act (IPA) assignees, fellows, student volunteers), in accordance with applicable law, agreement, and NSF policy. Consistent with Federal law, including title VII of the Civil Rights Act of 1964, the Americans with Disabilities Act (ADA), the Rehabilitation Act of 1973, and Equal Employment Opportunity Commission (EEOC) regulations, all such individuals must be afforded the right to request reasonable accommodation from this vaccination requirement on medical or religious grounds. Accordingly, NSF requests emergency clearance under the Paperwork Reduction Act (PRA), as provided in 5 CFR 1320.13 (emergency processing), in order to conduct this collection of information in order to make expedited reasonable accommodation determinations required under Federal law before the vaccination requirement goes into effect.

Emergency Justfication: Emergency clearance is being requested to allow sufficient time for individuals to request a reasonable accommodation based on medical or religious grounds, and for NSF to make the required reasonable accommodation or legal exception determinations. NSF, based on initial staff feedback, has provided below a rough estimate of how many of its 1000+ staff may request such a determination. Each such determination must be made on a case-by-case basis before the vaccination requirement is scheduled to take effect on November 22, 2021. Prior to the expiration of the 180-day emergency approval period, NSF intends to make a regular PRA clearance submission to allow this information collection activity to continue for three years, because NSF will continue to need to collect the information at issue (e.g., from new employees or other new NSF staff), until the COVID-19 public health emergency has abated, or the COVID19 vaccination requirement has been rescinded.

---

Authorizing Statute(s): US Code: 42 USC 1861 et seq. Name of Law: NSF Act of 1950, as amended
  

Citations for New Statutory Requirements: None

---

Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

---

Federal Register Notices & Comments

Did the Agency receive public comments on this ICR? No

---

Number of Information Collection (IC) in this ICR: 2

IC Title	Form No.	Form Name
NSF Request for a Medical Exception to the COVID-19 Vaccination Requirement	NSF	NSF Medical Reasonable Accommodation Request
Religious Reasonable Accommodation Request	NSF	NSF Religious Reasonable Accommodation

---

ICR Summary of Burden

	Total Request	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	200	0	0	200	0	0
Annual Time Burden (Hours)	300	0	0	300	0	0
Annual Cost Burden (Dollars)	23,536	0	0	23,536	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: This is a new collection for the National Science Foundation

---

Annual Cost to Federal Government: $63,001

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     Yes

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     Yes

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Yes

---

Common Form ICR:  No

---

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 11/10/2021

---