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Form OPM 5062 OPM 5062 Certification Vaccination Employee
Certification of Vaccination Form
CertificationVaccinationEmployeesFinal
Certification of Vaccination Common Form
OMB: 3206-0277
OMB.report
HHS/ACF
OMB 3206-0277
ICR 202206-0970-001CF
IC 249140
Form OPM 5062 OPM 5062 Certification Vaccination Employee
( )
⚠️ Notice: This form may be outdated. More recent filings and information on OMB 3206-0277 can be found here:
2022-06-08 - RCF New
Document [pdf]
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pdf
File Type
application/pdf
File Title
Certification of Vaccination
Subject
Form for certifying vaccination status of Federal employees
Author
United States Office of Personnel Management
File Modified
2021-08-18
File Created
2021-08-18
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