OMB.report

Federal forms, ICRs, and supporting documents

OMB control number

Submissions Related to the COVID-19 Vaccination Requirement

OMB 3084-0170 · FTC.

OMB 3084-0170

Latest Forms, Documents, and Supporting Material

Document Name
Form Not Applicable Vaccination Certification Requirements for Prospective Employees with Federal Job Offers Form and Instruction
Form Unknown Medical Certification for COVID-19 Vaccine Exception for Federal Employees Form and Instruction
Medical Exception Request-letter-11_8_21.pdf Supplementary Document
Medical Exception Request-Letter-11_4_21.pdf Supplementary Document
Supplemental Supporting Statement for New Employee Hires-11-30-2021-FINAL.pdf Supporting Statement A
Medical Certification for COVID-19 Vaccine Exception for Prospective Employees with Job Offer Other-Emergency Justification Letter
Vaccination Certification Requirements for Prospective Employees with Federal Job Offers Form and Instruction
Medical Certification for COVID-19 Vaccine Exception for Federal Employees Form and Instruction

All Historical Document Collections

202111-3084-003 Approved without change	Revision of a currently approved collection	2021-11-30
202111-3084-001 Approved without change	New collection (Request for a new OMB Control Number)	2021-11-05