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

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

⚠️ Notice: This information collection may be referencing outdated material.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

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
No associated records found

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