OMB control number
Request for a Medical or Religious Exception or Delay to the COVID-19 Vaccination Requirement
OMB 1225-0092 ยท DOL/DM.
OMB 1225-0092
Latest Forms, Documents, and Supporting Material
| Document | Type |
|---|---|
 Form DL1-7071A Request for a Religious Exception to the Covid-19 Vaccination Requirement | Form and Instruction |
| Form DL1-7071 Request for a Medical Exception to the COVID-19 Vaccination Requirement | Form and Instruction |
 1225-0092 SS 5.25.22 FINAL.docx | Supporting Statement A |
| SORN OASAM-38.pdf | Supplementary Document |
| OPM GOVT-10 SORN.pdf | Supplementary Document |
| DOL_CENTRAL-6 _ SORN.pdf | Supplementary Document |
 Request for a Religious Exception to the Covid-19 Vaccination Requirement |
Form and Instruction |
| Request for a Medical Exception to the COVID-19 Vaccination Requirement |
Form and Instruction |
All Historical Document Collections
| Reference | Filing | Received | Concluded | Action |
|---|---|---|---|---|
| 202205-1225-003 | Revision of a currently approved collection | 2022-05-26 | ||
| 202111-1225-001 | New collection (Request for a new OMB Control Number) | 2021-11-15 | Approved without change |