View RCF  - OIRA Conclusion

Active 02/28/2022
SEC 270-826
3206-0277 202108-3206-003
Certification of Vaccination Common Form
 Approved without change   10/12/2021
Retrieve Notice of Action (NOA) 10/12/2021
SEC will require employees to complete and submit this form. SEC will require contractors and visitors to complete this form and produce it upon request.
John Pezzullo 202 551-8118 [email protected]

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Certification of Vaccination Common Form 3,737 125 3,034 Form 3206-0277 Certification of Vaccination Common Form
Form and Instruction OPM 5062 Certification Vaccination Employee
Form and Instruction 3206-0277 Certification Vaccination PRA

  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 3,737 0 0 3,737 0 0
Annual Time Burden (Hours) 125 0 0 125 0 0
Annual Cost Burden (Dollars) 3,034 0 0 3,034 0 0

Miscellaneous Actions
The burden increased in alignment with the anticipated number of respondents.