OMB control number

Certification of Vaccination

OMB 3170-0075 · CFPB.

OMB 3170-0075

Latest Forms, Documents, and Supporting Material

Document Name
Certification of Vaccination Form and Instruction
EO 13991.pdf Supplementary Document
3170-0075 supporting statement.docx Supporting Statement A
3170-0075 30-day FRN (published).pdf Supplementary Document
3170-0075 60-day FRN (published).pdf Supplementary Document
Certification of Vaccination Form and Instruction

All Historical Document Collections

202201-3170-001 Approved without change	Extension without change of a currently approved collection	2022-02-09
202109-3170-002 Approved with change	New collection (Request for a new OMB Control Number)	2021-09-14