Form OPM 5062 OPM 5062 Certification Vaccination Employee

Certification of COVID-19 Vaccination Status

⚠️ Notice: This form may be outdated. More recent filings and information on OMB 3206-0277 can be found here:

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File Type	application/pdf
File Title	Certification of Vaccination
Subject	Form for certifying vaccination status of Federal employees
Author	United States Office of Personnel Management
File Modified	2021-08-18
File Created	2021-08-18