View RCF - OIRA Conclusion

Title: FHFA Certification of Vaccination

Type of RCF: RCF Recertification
OIRA Conclusion Action: Approved	Conclusion Date: 08/26/2021
Retrieve Notice of Action (NOA)	Date Received in OIRA: 08/26/2021
Terms of Clearance:

Description of Agency Usage: OIRA authorized any Agency to begin using the Certification of Vaccination Common Form (OMB No. 3206-0277) automatically. That information collection was established in order to promote the safety of Federal buildings, the Federal workforce, and others on site at agency facilities consistent with the COVID-19 Workplace Safety: Agency Model Safety Principles established by the Safer Federal Workforce Task Force and guidance from the Centers for Disease Control and Prevention and the Occupational Safety and Health Administration. Specifically, this information will be used by FHFA staff charged with implementing and enforcing workplace safety protocols.

Authorizing Statute(s): EO: EO 13991 Name/Subject of EO: Protecting the Federal Workforce and Requiring Mask-Wearing

Annual Cost to Federal Government: $1,612
Agency Contact: Angella Supervielle 202 649-3973 [email protected]

Common Form Information Collections (IC) in this RCF:

IC Title	Responses	Hours	Dollars	Document Type	Form No.	Form Name
Certification of Vaccination Common Form	3,600	108	2,923	Form	3206-0277	Certification of Vaccination Common Form
				Form and Instruction	OPM 5062	Certification Vaccination Employee
				Form and Instruction	3206-0277	Certification Vaccination PRA

RCF Summary of Burden:

	Total Approved	Previously Approved	Change Due to Adjustment in Estimate
Annual Number of Responses	3,600	3,600	0
Annual Time Burden (Hours)	108	120	-12
Annual Cost Burden (Dollars)	2,923	2,923	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Changing Regulations

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement:

202108-2590-002CF