layout table

View RCF  - OIRA Conclusion

Reginfo record details
Reginfo record details
202205-1205-001CF 202108-1205-002CF
Active 05/31/2025
DOL/ETA
3206-0277 202202-3206-002
Reginfo record details
Title: Certification of Vaccination
Reginfo record details
RCF Recertification
 Approved   05/24/2022
Retrieve Notice of Action (NOA) 05/24/2022
Reginfo record details
ETA will use this form to prevent the spread of COVID-19, and to protect the health and safety of all persons in DOL's Job Corps. Centers.
Reginfo record details
EO: EO 13991 Name/Subject of EO: Protecting the Federal Workforce and Requiring Mask-Wearing
Reginfo record details
 $0
Agency Contact: Mara Blumenthal 202 693-8538 [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 12,000 360 10,802 Form and Instruction OPM 5062 Certification Vaccination Employee
Form and Instruction CV2 Certification of Vaccination Common Form

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 12,000 12,000 0 0 0 0
Annual Time Burden (Hours) 360 400 0 0 -40 0
Annual Cost Burden (Dollars) 10,802 9,744 0 0 1,058 0