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Federal forms, ICRs, and supporting documents

Information Collection Request

Request for a Medical Exception to the COVID-19 Vaccination Requirement

ICR 202205-1902-009 · OMB 1902-0320 · Received in OIRA

Forms and Documents
DocumentTypeStatusAvailability
Form 1000 REQUEST FOR A MEDICAL EXCEPTION TO THE COVID-19 VACCINATION REQUIREMENT Form and Instruction Modified Repair queued
2022-05641 Federal Register 60 Day.pdf Supplementary Document Uploaded 2022-05-25 Repair queued
FERC-1000 60-day Notice 3-11-22.docx Supplementary Document Uploaded 2022-05-25 Repair queued
2022-11038 30 Day Notice Published FR.pdf Supplementary Document Uploaded 2022-05-25 Repair queued
Final_FERC-1000 30-Day Notice_5_17_2022.docx Supplementary Document Uploaded 2022-05-25 Repair queued
Final_FERC 1000 Supp. Statement.docx Supporting Statement A Uploaded 2022-05-25 Repair queued
1000_EO13164_00-19323.pdf Supplementary Document Uploaded 2021-11-10 Repair queued
1000_29USC791.docx Supplementary Document Uploaded 2021-11-10 Repair queued
1000_eCFR __ 29 CFR Part 1614 -- Federal Sector Equal Employment Opportunity.pdf Supplementary Document Uploaded 2021-11-10 Repair queued
1000_2021-01766_EO maskwearing1-20-21.pdf Supplementary Document Uploaded 2021-11-10 Repair queued
1000_Executive Order on Requiring Coronavirus Disease 2019 Vaccination for Federal Employees _ The White House.pdf Supplementary Document Uploaded 2021-11-10 Repair queued
Letter seeking emergency processing 11 8 2021.pdf Supplementary Document Uploaded 2021-11-08 Repair queued
IC Document Collections
IC IDCollectionTypeStatusForm
250289 REQUEST FOR A MEDICAL EXCEPTION TO THE COVID-19 VACCINATION REQUIREMENT Form and Instruction Modified
ICR Details
1902-0320 202205-1902-009
Received in OIRA 202111-1902-002
FERC FERC-1000
Request for a Medical Exception to the COVID-19 Vaccination Requirement
Extension without change of a currently approved collection   No
Regular 05/25/2022
  Requested Previously Approved
36 Months From Approved 05/31/2022
24 24
12 12
0 0
The purpose of this information collection request is to allow the Commission to collect information from individuals applying for a medical exception to the COVID-19 Vaccination Requirement as specified in Part 2 of FERC Form No. 1000.
US Code: 29 USC 791 Name of Law: Rehabilitation Act
   EO: EO 14043 Name/Subject of EO: Requiring COVID-19 vaccination for federal employees
  
None
Not associated with rulemaking
  87 FR 15235 03/17/2022
87 FR 31226 05/23/2022
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 24 24 0 0 0 0
Annual Time Burden (Hours) 12 12 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No
$10,007
No
    Yes
    Yes
No
No
No
Yes
Christopher Kozler 734 239-3294 [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.
05/25/2022