View RCF - OIRA Conclusion

Title: CPSC Certification of Vaccination

Type of RCF: RCF Recertification
OIRA Conclusion Action: Approved	Conclusion Date: 05/24/2022
Retrieve Notice of Action (NOA)	Date Received in OIRA: 05/24/2022
Terms of Clearance:

Description of Agency Usage: The purpose of this collection is to take steps 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.

Authorizing Statute(s): None

Annual Cost to Federal Government:
Agency Contact: Cynthia Gillham 301 504-7701 cgillham@cpsc.gov

Common Form Information Collections (IC) in this RCF:

IC Title	Status	Responses	Hours	Dollars	Document Type	Form No.	Form Name
Certification of Vaccination Common Form		230	7	207	Form and Instruction	OPM 5062	Certification Vaccination Employee
Certification of Vaccination Common Form		230	7	207	Form and Instruction	CV2	Certification of Vaccination Common Form

RCF Summary of Burden:

	Total Approved	Previously Approved	Change Due to Adjustment in Estimate
Annual Number of Responses	230	230	0
Annual Time Burden (Hours)	7	7	0
Annual Cost Burden (Dollars)	207	187	20

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: