Requiring Coronavirus Disease 2019 Vaccination for Federal Employees

Request for a Medical Exception to the COVID-19 Vaccination Requirement

OMB: 3240-0040

IC ID: 251114

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Requiring Coronavirus Disease 2019 Vaccination for Federal Employees
 
No Unchanged
 
Required to Obtain or Retain Benefits
 
5 CFR 1320.13

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability

Health Public Health Monitoring

Reasonable Accommodation, Religious Exception, and Medical Exception Health Records  87 FR 2199

8 8
   
Federal Government
 
   0 %

  Requested Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 8 0 0 0 0 8
Annual IC Time Burden (Hours) 20 0 0 0 0 20
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Emergency Letter to OMB OIRA Emergency letter ICR.pdf 01/12/2022
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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