202108-1225-001CF
RCF
OMB: 3206-0277
Array
(
[refNbr] => 202108-1225-001CF
[obm] => 3206-0277
[icr] => 202108-3206-001
[status] => Active
[agency] => DOL/DM
[title] => Certification of Vaccination
[typeRCF] => RCF New
[oiraAction] => Approved without change
[oiraNOA] => 354959
[termsOfClearance] =>
[previousRCF] =>
[agencyTrackingNo] =>
[conclusionDate] => 2021-08-12
[dateReceived] => 2021-08-12
)
Document
View RCF
- OIRA Conclusion
| 202108-1225-001CF |
|
|
Active
|
02/28/2022 |
| DOL/DM |
|
| 3206-0277 |
202108-3206-001 |
| Certification of Vaccination |
|
RCF New
|
| Approved without change |
08/12/2021
|
|
Retrieve Notice of Action (NOA)
|
08/12/2021
|
|
|
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The Department will use this form to prevent the spread of COVID-19, and to protect the health and safety of all persons in DOL buildings.
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EO: EO 13991 Name/Subject of EO: Protecting the Federal Workforce and Requiring Mask-Wearing
|
|
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Mara Blumenthal 202 693-8538 blumenthal.mara@dol.gov
|
|
| |
Total Approved |
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 |
4,000 |
0 |
0 |
4,000 |
0 |
0 |
| Annual Time Burden (Hours) |
133 |
0 |
0 |
133 |
0 |
0 |
| Annual Cost Burden (Dollars) |
3,248 |
0 |
0 |
3,248 |
0 |
0 |
|
Yes
|
|
Miscellaneous Actions
|
|
No
|
|
|
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The burden requested reflects the Department's projected usage of the common form.
|
|
|