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Certification of Vaccination Common Form

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form 3206-0277 Certification of Vaccination Common Form CertificationVaccinationPRAv6.pdf No   Printable Only
Form and Instruction OPM 5062 Certification Vaccination Employee CertificationVaccinationEmployeesFinal.pdf Yes Yes Fillable Fileable Signable
Form and Instruction 3206-0277 Certification Vaccination PRA CertificationVaccinationPRAfinal.pdf Yes Yes Fillable Printable

General Government Executive Functions


3,600 0
Individuals or Households
   0 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 3,600 0 0 0 0 3,600
Annual IC Time Burden (Hours) 108 0 0 -12 0 120
Annual IC Cost Burden (Dollars) 2,923 0 0 0 0 2,923

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