layout table

View RCF  - OIRA Conclusion

Reginfo record details
Reginfo record details
202108-3240-002CF 202108-3240-001CF
Active 02/28/2022
SSS
3206-0277 202108-3206-003
Reginfo record details
Title: Certification of Vaccination
Reginfo record details
RCF Recertification
 Approved   08/26/2021
Retrieve Notice of Action (NOA) 08/26/2021
Reginfo record details
The form will be used by Selective Service System Contractors and Visitors. Contractors and Visitors will have to retain (once completed) to show as requested for entry.
Reginfo record details
EO: EO 13991 Name/Subject of EO: Protecting the Federal Workforce and Requiring Mask Wearing
Reginfo record details
 $162
Agency Contact: Betty Lou Wingo 703 605-4005 [email protected]

table that charts list of ICs
IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Certification of Vaccination Common Form 200 6 162 Form 3206-0277 Certification of Vaccination Common Form
Form and Instruction OPM 5062 Certification Vaccination Employee
Form and Instruction 3206-0277 Certification Vaccination PRA

table that charts list of burden
  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 200 200 0 0 0 0
Annual Time Burden (Hours) 6 7 0 0 -1 0
Annual Cost Burden (Dollars) 162 162 0 0 0 0