Document

Certification of Vaccination

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

Document Viewer [docx]

Status: The document is viewable, but some background extraction is still pending.

Queue: Repair is in progress, but the document is still incomplete and remains in the worker queue. (priority 70 · next 2026-05-10 07:57:17)

Missing: html

Download: Source copy (docx)

Primary: docxSource: application/vnd.openxmlformats-officedocument.wordprocessingml.document
Loading document viewer…

Document Metadata

Record metadata
application/vnd.openxmlformats-officedocument.wordprocessingml.document
Certification of Vaccination
Form for certifying vaccination status. OMB Control No. 3206-0277, expires February 5, 2022
United States Office of Personnel Management
2022-04-04
partial