The NIGC will use this form to prevent the spread of COVID-19 and to
protect the health and safety of all Federal employees, onsite contractors,
visitors to Federal buildings or Federally controlled indoor workspaces, and
other individuals interacting with the Federal workforce.
EO: EO 13991 Name/Subject of EO: Protecting the Federal Workforce and Requiring Mask-Wearing
EO: EO 12196 Name/Subject of EO: Occupational Safety and Health Program for Federal Employees
US Code:
5 USC Chapters 11 and 79
Tim Osumi 202 632-7054 tim_osumi@nigc.gov
IC Title
Status
Responses
Hours
Dollars
Document Type
Form No.
Form Name
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
100
0
0
100
0
0
Annual Time Burden (Hours)
3
0
0
3
0
0
Annual Cost Burden (Dollars)
81
0
0
81
0
0
Yes
Miscellaneous Actions
No
The NIGC will use this form to prevent the spread of COVID-19 and to protect the health and safety of all Federal employees, onsite contractors, visitors to Federal Buildings or Federally controlled indoor workspaces, and other individuals interacting with the Federal workforce.