Information Collection

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

IC 250275 under ICR 202201-3209-001 · OMB 3209-0011.

Documents and Forms

Documents and forms in this information collection
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 Form 319.pdf	Form and Instruction

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of 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 Form 319.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 %

table that charts list of burden
	Requested	Previously Approved
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

table that charts IC Documents
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.