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Staff, Contractor, and Volunteer Reporting of New Vaccination
Recordkeeping for New Vaccine and Mask Requirements to Mitigate the Spread of COVID-19 in Head Start
OMB: 0970-0583
IC ID: 250754
OMB.report
HHS/ACF
OMB 0970-0583
ICR 202301-0970-005
IC 250754
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0583 can be found here:
2023-06-30 - Revision of a currently approved collection
Documents and Forms
Document Name
Document Type
no available documents/forms check other ICs listed under this ICR
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Staff, Contractor, and Volunteer Reporting of New Vaccination
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Modified
Obligation to Respond:
Mandatory
CFR Citation:
45 CFR 1302
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Federal Enterprise Architecture Business Reference Module
Line of Business:
Community and Social Services
Subfunction:
Social Services
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
75,000
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
0 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
75,000
0
0
0
0
75,000
Annual IC Time Burden (Hours)
50,003
0
0
0
0
50,003
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
No associated records found
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.