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Certification of Vaccination

ICR 202201-3170-001 · OMB 3170-0075 · Object 118046101.

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File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
File TitleCertification of Vaccination
SubjectForm for certifying vaccination status. OMB Control No. 3206-0277, expires February 5, 2022
AuthorUnited States Office of Personnel Management
File Created2022-04-04
Conversion Statepartial