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Request for a Medical Exception to the COVID-19 Vaccination Requirement
OMB 3440-0002
OMB.report
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OMB 3440-0002
OMB 3440-0002
Latest Forms, Documents, and Supporting Material
Document
Name
Form 1 Request for a Medical Exception to the COVID-19 Vaccination Requirement
Form
11-08-21_LTR_Medical Exceptions_21-01789_U_Initial.pdf
Supporting Statement B
ATTACH 2 (Support Statement A)_U.pdf
Supporting Statement A
Request for a Medical Exception to the COVID-19 Vaccination Requirement
Form
All Historical Document Collections
202111-3440-002
Approved without change
New collection (Request for a new OMB Control Number)
2021-11-15
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