Information Collection

OGE Request For a Medical Exception to the Covid-19 Vaccination Requirement (pdf)

IC 250275 under ICR 202111-3209-001 · OMB 3209-0011.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3209-0011 can be found here:

Documents and Forms

Document Name Document Type
Form OGE Form 319 OGE Request For a Medical Exception to the Covid-19 Vaccination Requirement (pdf) Form and Instruction
OGE Form 319 OGE Request for a Medical Exception to the Covid-19 Vacc OGE Request for a Medical Exception to the Covid-19 Vaccination Requirement.pdf Form and Instruction
OGE Form 319 OGE Request for a Medical Exception to the Covid-19 Vacc OGE Request for a Medical Exception to the Covid-19 Vaccination Requirement.pdf Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	OGE Request For a Medical Exception to the Covid-19 Vaccination Requirement (pdf)	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	OGE Form 319	OGE Request for a Medical Exception to the Covid-19 Vaccination Requirement	OGE Request for a Medical Exception to the Covid-19 Vaccination Requirement.pdf		Yes	No	Fillable Printable

Line of Business: General Government

Subfunction: Executive Functions

Privacy Act System of Records
Title: OGE/INTERNAL-1, Pay, Leave, Travel, and Reasonable Accommodation Records	FR Citation: 86 FR 62537

Number of Respondents: 5	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	1	1
Annual IC Time Burden (Hours)	0	0
Annual IC Cost Burden (Dollars)	17	17

Documents for IC

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