OMB control number

Disability Qualification Determination

OMB 3037-0012 · CPBSD.

OMB 3037-0012

The form will be used by the AbilityOne Program to determine eligibility as a qualified direct labor employee whose work will be counted as hours performed by a blind or significantly disabled individual as required by the JWOD Act (41 USC 85) U.S. AbilityOne Commission Compliance Policy 51.403.

The latest form for Disability Qualification Determination expires 2028-03-31 and is listed under ICR 202410-3037-002.

View the official OMB control history on Reginfo.gov.

Latest Forms, Documents, and Supporting Material

Latest forms, documents, and information collections
Document	Type
Form 3037-0012 Disability Qualification Determination (document unavailable)	Form and Instruction
Disability Qualification Determination	Form
Form 3037-0011 Individual Eligibility Eligibility	Form
INDIVIDUAL ELIGIBILITY EVALUATION (3).dotx (document unavailable)	Supplementary Document
Redlined IEE.pdf	Supplementary Document
Redlined IEE.pdf	Supplementary Document
Form 1 Supporting Statement_CLEAN 1.17.2025.docx	Supporting Statement A
Form 1 supporting statement - Inspected.docx	Supporting Statement A
2024-24384.pdf	Supplementary Document
2024-24384.pdf	Supplementary Document
INDIVIDUAL ELIGIBILITY EVALUATION (3).dotx	Supplementary Document
INDIVIDUAL ELIGIBILITY EVALUATION (3).dotx	Supplementary Document
Commission Policy 51.403 Determining Eligibility of Participating Employees signed-2Aug2024-a.pdf	Supplementary Document
Commission Policy 51.403 Determining Eligibility of Participating Employees signed-2Aug2024-a.pdf	Supplementary Document
41 CFR 51-4.3 (up to date as of 10-09-2024) (1).pdf	Supplementary Document
41 CFR 51-4.3 (up to date as of 10-09-2024) (1).pdf	Supplementary Document
form 1 60-day notice 2023-25499.pdf	Supplementary Document
form 1 60-day notice 2023-25499.pdf	Supplementary Document
Form 1 30-day Notice.docx	Supplementary Document
Form 1 30-day Notice.docx	Supplementary Document
Disability Qualification Determination	Form and Instruction
Disability Qualification Determination	Form
Individual Eligibility Evaluation Form	Form
Individual Eligibility Evaluation Form	Instruction

All Historical Document Collections

Historical document collections
Reference	Filing	Received	Concluded	Action
202410-3037-002	Reinstatement with change of a previously approved collection	2024-10-24
201204-3037-001	New collection (Request for a new OMB Control Number)	2012-09-17		Approved without change

OMB Details

Individual Eligibility Evaluation Form

Federal Enterprise Architecture: Economic Development - Business and Industry Development

Information collection instruments
Form	Name	Electronic access	Type
Form 3037-0011	Individual Eligibility Eligibility	Paper Only	Form

Review document collections for all forms, instructions, and supporting documents - including paper/printable forms.