OMB.report

Federal forms, ICRs, and supporting documents

OMB control number

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

OMB 1225-0092 · DOL/DM.

OMB 1225-0092

Latest Forms, Documents, and Supporting Material

Document Name
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All Historical Document Collections

202205-1225-003	Revision of a currently approved collection	2022-05-26
202111-1225-001 Approved without change	New collection (Request for a new OMB Control Number)	2021-11-15