View RCF
- OIRA Conclusion
RCF ID: 202205-1557-001CFPrevious RCF ID: 202110-1557-001CF
Status:
Active
Expiration Date: 05/31/2025
Agency/Subagency: TREAS/OCCAgency Tracking No:
Host OMB Control No: 3206-0277Host ICR Reference No: 202202-3206-002
Title: Certification of Vaccination
Type of RCF: RCF Recertification
OIRA Conclusion Action: ApprovedConclusion Date:
05/24/2022
Retrieve Notice of Action (NOA)
Date Received in OIRA:
05/24/2022
Terms of Clearance:
Description of Agency Usage:
The purpose of this form is to take steps to prevent the spread of COVID-19, to protect the health and safety of all Federal employees, onsite contractors, visitors to Federal buildings or Federally controlled indoor workspaces, and other individuals interacting with the Federal workforce.
Authorizing Statute(s):
US Code:
12 USC 1 et seq.
Name of Law: The National Bank Act
Annual Cost to Federal Government:
Agency Contact:
Kristin Merritt 202 649-5585
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
2,320
70
2,088
Form and Instruction
OPM 5062
Certification Vaccination Employee
Form and Instruction
CV2
Certification of Vaccination Common Form
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
2,320
2,320
0
0
0
0
Annual Time Burden (Hours)
70
77
0
0
-7
0
Annual Cost Burden (Dollars)
2,088
1,884
0
0
204
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: