OMB.report

Federal forms, ICRs, and supporting documents

OMB control number

Submissions Related to the COVID-19 Vaccination Requirement

OMB 3084-0170 · FTC.

OMB 3084-0170

Latest Forms, Documents, and Supporting Material

Latest forms, documents, and information collections
Document	Type
Form Not Applicable Letter for Final Job Offer	Form and Instruction
Form Not Applicable Vaccination Certification Requirements for Prospective Employees with Federal Job Offers	Form and Instruction
Form Not Applicable Privacy Act Statement for Medical Exception Form to COVID-19 Vaccination Requirement	Form
Form Unknown Request for a Medical Exception to the COVID-19 Vaccination Requirement	Form and Instruction
Form Unknown Medical Certification for COVID-19 Vaccine Exception for Federal Employees	Form and Instruction
Medical Exception Request-letter-11_8_21.pdf	Supplementary Document
Medical Exception Request-Letter-11_4_21.pdf	Supplementary Document
Supplemental Supporting Statement for New Employee Hires-11-30-2021-FINAL.pdf	Supporting Statement A
Medical Certification for COVID-19 Vaccine Exception for Prospective Employees with Job Offer	Other-Emergency Justification Letter
Vaccination Certification Requirements for Prospective Employees with Federal Job Offers	Form and Instruction
Vaccination Certification Requirements for Prospective Employees with Federal Job Offers	Form and Instruction
Vaccination Certification Requirements for Prospective Employees with Federal Job Offers	Other-Emergency Request Letter
Medical Certification for COVID-19 Vaccine Exception for Federal Employees	Form
Medical Certification for COVID-19 Vaccine Exception for Federal Employees	Form and Instruction
Medical Certification for COVID-19 Vaccine Exception for Federal Employees	Form and Instruction

All Historical Document Collections

Historical document collections
Reference	Filing	Received	Concluded	Action
202111-3084-003	Revision of a currently approved collection	2021-11-30		Approved without change
202111-3084-001	New collection (Request for a new OMB Control Number)	2021-11-05		Approved without change