202108-3209-002CF RCF OMB: 3206-0277
OMB.report
OMB 3206-0277
RCF 202108-3209-002CF
( RCF Recertification )
Array
(
[refNbr] => 202108-3209-002CF
[obm] => 3206-0277
[icr] => 202108-3206-003
[status] => Active
[agency] => OGE
[title] => Certification of Vaccination
[typeRCF] => RCF Recertification
[oiraAction] => Approved
[oiraNOA] => 357980
[termsOfClearance] =>
[previousRCF] => 202108-3209-001CF
[agencyTrackingNo] =>
[conclusionDate] => 2021-08-26
[dateReceived] => 2021-08-26
)
Document
View RCF
- OIRA Conclusion
RCF ID: 202108-3209-002CFPrevious RCF ID: 202108-3209-001CF
Status:
Active
Expiration Date: 02/28/2022
Agency/Subagency: OGEAgency Tracking No:
Host OMB Control No: 3206-0277Host ICR Reference No: 202108-3206-003
Title: Certification of Vaccination
Type of RCF: RCF Recertification
OIRA Conclusion Action: ApprovedConclusion Date:
08/26/2021
Retrieve Notice of Action (NOA)
Date Received in OIRA:
08/26/2021
Terms of Clearance:
Description of Agency Usage:
The agency has been directed to ask about the vaccination status of onsite contractors and visitors. Onsite contractors and visitors must sign an attestation confirming their vaccine status. They must show the attestation before being allowed access to the office space and upon request while in agency-controlled space.
Authorizing Statute(s):
None
Annual Cost to Federal Government: $0
Agency Contact:
Jennifer Matis 202 482-9216 jennifer.matis@oge.gov
Common Form Information Collections (IC) in this RCF:
IC Title
Status
Responses
Hours
Dollars
Document Type
Form No.
Form Name
Certification of Vaccination Common Form
100
3
81
Form
3206-0277
Certification of Vaccination Common Form
Form and Instruction
OPM 5062
Certification Vaccination Employee
Form and Instruction
3206-0277
Certification Vaccination PRA
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
100
100
0
0
0
0
Annual Time Burden (Hours)
3
3
0
0
0
0
Annual Cost Burden (Dollars)
81
81
0
0
0
0
Burden increases because of Program Change due to Agency Discretion:
Yes
Burden Increase Due to:
Miscellaneous Actions
Burden decreases because of Program Change due to Agency Discretion:
No
Burden Reduction Due to:
Short Statement: