View RCF  - OIRA Conclusion

202108-0412-003CF
Active 05/31/2022
AID
3206-0277 202108-3206-003
Certification of Vaccination Form
RCF New
 Approved without change   01/03/2022
Retrieve Notice of Action (NOA) 12/30/2021
The purpose of this collection is to prevent the spread of COVID-19, to protect the health and safety of Federal employees, onsite contractors, and visitors and individuals interacting with the Federal workforce. The form will be used for the attestation of vaccine status by Federal employees, contractors, and visitors.
None
 
Taniesha Tolbert 202 712-1217 ttolbert@usaid.gov

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Certification of Vaccination Common Form 5,384 179 4,372 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 5,384 0 0 5,384 0 0
Annual Time Burden (Hours) 179 0 0 179 0 0
Annual Cost Burden (Dollars) 4,372 0 0 4,372 0 0

Yes
Miscellaneous Actions
No
New Collection