Home OMB 3206-0277 ICR 202108-3206-001 RCF 202108-3170-001CF Regulatory Collection Filing
Certification of Vaccination (CFPB) RCF 202108-3170-001CF · 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 CFPB 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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View RCF
- Agency Submission
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RCF ID: 202108-3170-001CFPrevious RCF ID:
Status:
Received in OIRA
Expiration Date: 02/28/2022
Agency/Subagency: CFPBAgency Tracking No:
Host OMB Control No: 3206-0277Host ICR Reference No: 202108-3206-001
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Title: Certification of Vaccination (CFPB)
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Type of RCF: RCF New
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Description of Agency Usage:
The Bureau will use this form to prevent the spread of COVID-19 and to protect the health and safety of all Federal employees, onsite contractors, visitors to Federal buildings or Federally controlled indoor workspaces, and other individuals interacting with the Federal workforce.
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Authorizing Statute(s):
EO: EO 13991 Name/Subject of EO: Protecting the Federal Workforce and Requiring Mask-Wearing
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Annual Cost to Federal Government: $0
Agency Contact:
Anthony May 202 502-6458 [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
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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
1,500
0
0
1,500
0
0
Annual Time Burden (Hours)
50
0
0
50
0
0
Annual Cost Burden (Dollars)
1,218
0
0
1,218
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:
The Bureau is not making any program changes or adjustments under our request to use the "Certification of Vaccination Common Form". The response and hourly burden requested reflects the Bureau's projected annual usage of the common form.