OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

COVID-19 Symptom Tracker for Students, Emotional Wellness Form for Students, and Student Vaccination Status and Test Consent Form Collection

ICR 202109-1205-003 · OMB 1205-0548 · Received in OIRA

Forms and Documents
DocumentTypeStatusAvailability
Emergency Clearance Request Letter 10.15.2021.pdf Supplementary Document Uploaded 2021-10-15 Missing upstream
PIN 21-04 Resumption of Traditional Enrollment 10.15.21.pdf Supplementary Document Uploaded 2021-10-15 Repair queued
PIN 21-03 Return of Non-Residential Students 10.15.21.pdf Supplementary Document Uploaded 2021-10-15 Repair queued
PIN 21-02 Revised Quarantine Requirements (004).pdf Supplementary Document Uploaded 2021-10-07 Repair queued
PIN 21-01 Vaccine Requirement and Records Process.pdf Supplementary Document Uploaded 2021-10-07 Missing upstream
1205-0NEW Supporting Statement 10.18.21.docx Supporting Statement A Uploaded 2021-10-18 Missing upstream
IC Document Collections
IC IDCollectionTypeStatusForm
249488 Student Vaccination Certification and Testing Consent Other-Attestation New
249486 COVID-19 Emotional Wellness -- Students Other-Attestation New
249485 COVID-19 Symptom Tracker -- Students Other-Attestation New
ICR Details
202109-1205-003
Received in OIRA
DOL/ETA
COVID-19 Symptom Tracker for Students, Emotional Wellness Form for Students, and Student Vaccination Status and Test Consent Form Collection
New collection (Request for a new OMB Control Number)   No
Emergency 10/22/2021
10/18/2021
  Requested Previously Approved
6 Months From Approved
7,320,000 0
2,415,600 0
0 0
This collection supplements Job Corps’ existing health collections to gather information that will allow Job Corps to safely mitigate the spread of COVID-19 and protect the safety and health of students during the ongoing pandemic.
The ICR is submitted with an emergency request because the information is essential to the mission of the ETA in 1) collecting data to assess the impact of COVID-19 and steps to prevent infection, and 2) supporting efforts in the reduction of the risk and spread of COVID-19 among Job Corps students and staff.
None
None
Not associated with rulemaking
No
  Total Request 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 7,320,000 0 0 7,320,000 0 0
Annual Time Burden (Hours) 2,415,600 0 0 2,415,600 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
Miscellaneous Actions
No
This is a new information collection request.
$0
No
    No
    No
No
No
No
Yes
Emily St. Onge 202 693-2605 [email protected]
  No
On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
10/18/2021