Submissions Related to the
COVID-19 Vaccination Requirement
Revision of a currently approved collection
No
Emergency
11/30/2021
11/30/2021
Requested
Previously Approved
6 Months From Approved
05/31/2022
89
35
16
6
0
0
On September 9, 2021, President Biden
issued Executive Order 14,043, which requires all Federal employees
as defined in 5 U.S.C. § 2105, to be vaccinated against COVID-19,
with exceptions only as required by law. Employees may seek a legal
exception to the vaccination requirement due to a disability, using
the template form provided by the Safer Federal Workforce Task
Force. Part one of the form, which is not subject to clearance
under the Paperwork Reduction Act (“PRA”), provides that the
individual employee would seek a medical exception to the
requirement for COVID-19 vaccination or a delay because of a
temporary condition or medical circumstance. Part two of the form,
which is to be completed by the employee’s medical provider, is
subject to clearance approval from the Office of Management and
Budget under the PRA. The FTC needs information requested on part
two of the form from the medical provider to effectively evaluate
the employee’s reasonable accommodation request. The FTC also needs
to collect vaccination certification documents from prospective
employees with a job offer. The purpose of this revised ICR is to
seek approval for this collection from prospective employees with a
job offer and from their medical provider if the prospective
employee requests a medical exception.
The FTC needs to collect
vaccination certification documents from prospective employees with
a job offer. The FTC also needs to collect data from medical
providers for prospective employees with a job offer that request a
medical exception as set out on part two of the medical exception
form. This is required by Executive Order 14043, Requiring
Coronavirus Disease 2019 Vaccination for Federal Employees (Sept.
9, 2021). Executive Order 14,043 directed the Safer Federal
Workforce Task Force to issue guidance within seven days of the
date of that order (Sept. 9, 2021) on implementation by federal
agencies covered by the order. The Task Force thereafter directed
that Federal employees must be fully vaccinated by November 22,
2021, other than in limited circumstances where the law requires an
exception. Agencies were also directed to require that individuals
who start their government service after November 22, 2021, be
fully vaccinated prior to their start date, except in limited
circumstances where an accommodation is legally required. The FTC
already has approval from the Office of Management and Budget for
information collections associated with Part II of the form
relating to medical exceptions to the vaccination requirement for
current federal employees.
EO: EO
13991 Name/Subject of EO: Protecting the Federal Workforce and
Requiring Mask-Wearing
EO: EO 12196 Name/Subject of EO: Occupational Safety
and Health Program for Federal Employees
US Code:
5 USC chapters 11 and 79
EO: EO 14043 Name/Subject of EO: Requiring
Coronavirus Disease 2019 Vaccination for Federal Employees
EO: EO 14043 Name/Subject of EO: Requiring
Coronavirus Disease 2019 Vaccination for Federal Employees
The FTC needs to collect
vaccination certification documents from prospective employees with
a job offer. Some prospective employees may seek a medical
exception to the vaccination requirement and the FTC would then
need to collect information from the medical provider for a
prospective employee to effectively assess the request for a
reasonable accommodation. This information collection was not part
of the prior clearance request and also needs authorization under
PRA to collect. This is also required by the President's Executive
Order 14,043.
No
Yes
Yes
No
No
No
No
Richard Gold 202 326-3355
rgold@ftc.gov
No
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.
Form Not Applicable Vaccination Certification Requirements for Prospective Employees with Federal Job Offers
Medical Exception Request-letter-11_8_21.pdf
Medical Certification for COVID-19 Vaccine Exception for Prospective Employees with Job Offer