Information Collection

Reasonable Accommodation Forms

IC 250571 under ICR 202111-3045-001 · OMB 3045-0196.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3045-0196 can be found here:

Documents and Forms

Document Name Document Type
Form 1 Reasonable Accommodation Forms Form
1 Reasonable Accommodation: Medical Exemption Request COVID 19 Medical Exemption writable.pdf www.nationalservice.gov Form
2 Reasonable Accommodation: Medical Request Medical Reasonable Accommodation writable.pdf www.nationalservice.gov Form
3 Reasonable Accommodation Form: Religious Religious Accommdation Form writable.pdf www.nationalservice.gov Form
3 Request Religious Exemption Request COVID 19 Religious Exemption writable.pdf www.nationalservice.gov Form

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Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.