No
material or nonsubstantive change to a currently approved
collection
Yes
Emergency
08/06/2021
08/24/2021
Requested
Previously Approved
02/28/2022
02/28/2022
1,500
1,500
50
50
1,218
1,218
Pursuant to Office of Management and
Budget (OMB) procedures established at 5 C.F.R. Part 1320,
Controlling Paperwork Burdens on the Public, I request that the
proposed information collection, the Certification of Vaccination
Common Form, OMB Control No. 3206-NEW, be processed as an Emergency
Clearance Request in accordance with 5 C.F.R. §1320.13, Emergency
Processing.Government agencies have an urgent need to request
attestation of vaccination status from individuals entering Federal
buildings and workspaces. Applying regular Paperwork Reduction Act
clearance procedures is likely to cause harm because of the threat
of COVID-19 exposure and transmission.
EO: EO
13991 Name/Subject of EO: Protecting the Federal Workforce and
Requiring Mask-Wearing
Charles Conyers 202 606-0125
charles.conyers@opm.gov
Yes
OIRA authorizes any Agency to begin using a Common
Form associated with this ICR automatically after 5 calendar days
from the date the agency's RCF including the common form was
received in OIRA.
Common Form ICR: Yes OIRA authorizes any
Agency to begin using a Common Form associated with this ICR
automatically after 5 calendar days from the date the agency's RCF
including the common form was received in OIRA. Description/Changes
for Common Form Usage: Approved and pending RCFs using this
ICR
Agency/Sub Agency
RCF ID
RCF Title
RCF Status
IC Title
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.