Home OMB 3206-0277 ICR 202108-3206-001 RCF 202108-2700-001CF Regulatory Collection Filing
NASA Certification of Vaccination RCF 202108-2700-001CF · Host ICR 202108-3206-001 · OMB 3206-0277
RCF Summary Request for correction metadata Host OMB Control No. 3206-0277 Host ICR Reference No. 202108-3206-001 Agency/Subagency NASA Status Received in OIRA Type of RCF RCF New OIRA Conclusion Action View RCF focusMethod = function getFocus() { document.getElementById("main").focus(); } .skip-main { border-color: transparent; Date Received in OIRA 1969-12-31 Conclusion Date 1969-12-31 Related Links OMB 3206-0277 · ICR 202108-3206-001
RCF Details
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- Agency Submission
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RCF ID: 202108-2700-001CFPrevious RCF ID:
Status:
Received in OIRA
Expiration Date: 02/28/2022
Agency/Subagency: NASAAgency Tracking No:
Host OMB Control No: 3206-0277Host ICR Reference No: 202108-3206-001
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Title: NASA Certification of Vaccination
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Type of RCF: RCF New
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Description of Agency Usage:
NASA will be creating an electronic version of the common form -- preserving all questions, formats, and accompanying language found on the common form -- to be used to capture vaccination information from agency civil servants, contractors, and affiliates. The number of respondents in this RCF (38,500) reflects NASA's contractors and affiliates only; civil servants are not included in this figure. NASA's electronic version will not add or remove questions from the common form, and the collected information will be stored and managed in the Electronic Health Record System, which is covered by SORN NASA 10HIMS (Health Information Management System).
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Authorizing Statute(s):
None
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Annual Cost to Federal Government: $1,500
Agency Contact:
Claire Little 650 604-2826 [email protected]
Common Form Information Collections (IC) in this RCF:
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IC Title
Status
Responses
Hours
Dollars
Document Type
Form No.
Form Name
table that charts list of burden
Total Request
Previously Approved
Change Due to New Statute
Change Due to Agency Discretion
Change Due to Adjustment in Estimate
Change Due to Potential Violation of the PRA
Annual Number of Responses
38,500
0
0
38,500
0
0
Annual Time Burden (Hours)
1,283
0
0
1,283
0
0
Annual Cost Burden (Dollars)
31,262
0
0
31,262
0
0
Burden increases because of Program Change due to Agency Discretion:
Yes
Burden Increase Due to:
Miscellaneous Actions
Burden decreases because of Program Change due to Agency Discretion:
No
Burden Reduction Due to:
Short Statement:
NASA has not used this Common Form before. As such, the previous burden was $0.