View RCF  - OIRA Conclusion

202108-3150-001CF
Active 02/28/2022
NRC
3206-0277 202108-3206-001
Certification of Vaccination
RCF New
 Approved without change   08/13/2021
Retrieve Notice of Action (NOA) 08/13/2021
The form will be used by NRC contractors and visitors to document their vaccination status. They will retain the completed form to show as requested for entry.
EO: EO 13991 Name/Subject of EO: Protecting the Federal Workforce and Requiring Mask Wearing
 $600
David Cullison 301 415-2084 [email protected]

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Certification of Vaccination Common Form 250 8 203 Form 3206-0277 Certification of Vaccination Common Form

  Total Approved 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 250 0 0 250 0 0
Annual Time Burden (Hours) 8 0 0 8 0 0
Annual Cost Burden (Dollars) 203 0 0 203 0 0

Yes
Miscellaneous Actions
No
This is a new collection required to comply with EO 13991