Staff, Contractor, and Volunteer Requesting and Processing Vaccination Exemption

Recordkeeping for New Vaccine and Mask Requirements to Mitigate the Spread of COVID-19 in Head Start

OMB: 0970-0583

IC ID: 250756

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Staff, Contractor, and Volunteer Requesting and Processing Vaccination Exemption
 
No Modified
 
Mandatory
 
45 CFR 1302

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

Community and Social Services Social Services

 

5,000 0
   
Individuals or Households
 
   0 %

  Approved 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 5,000 0 0 0 0 5,000
Annual IC Time Burden (Hours) 2,500 0 0 0 0 2,500
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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