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

OMB 3060-1295

Latest Forms, Documents, and Supporting Material

Document Name
Form FCC Form 5643 Federal Government Form and Instruction
Form FCC Form 5643 Business or other for-profit Form and Instruction
Form FCC Form 5643 Individuals or Households Form and Instruction
3060-1295 Explanation of Non-Substantive Changes for Medical Exemption Form_12.6.21.docx Justification for No Material/Nonsubstantive Change
Emergency PRA Approval Cover Letter for Collecting Info for COVID Medical Exemption Form_10.-29-21 signed.pdf Supplementary Document
Emergency PRA Supporting Statement for COVID Medical Exemption (final version).docx Supporting Statement A
Federal Government Form and Instruction
Business or other for-profit Form and Instruction
Individuals or Households Form and Instruction