Document
Information Collection Being Reviewed by the Federal Communications Commission
As part of its continuing effort to reduce paperwork burdens, and as required by the Paperwork Reduction Act (PRA) of 1995, the Federal Communications Commission (FCC or the Com...
SUPPLEMENTARY INFORMATION:
OMB Control Number:
3060-1297.
Title:
COVID-19 Vaccine Attestation Form for Non-paid Employees.
Form No.:
FCC Form 5644.
Type of Review:
Revision of a currently approved collection.
Respondents:
Individuals or households.
Number of Respondents and Responses:
140 respondents and 140 responses.
Estimated Time per Response:
0.25 hours.
Frequency of Response:
One-time reporting requirement.
Obligation to Respond:
Mandatory. The statutory authority to collect this information derives from General Duty Clause; Section 5(a)(1) of the Occupational Safety and Health (OSH) Act of 1970 (29 U.S.C. 654); Executive Order 12196, Occupational safety and health programs for Federal employees (Feb. 26, 1980); Executive Order 13991, Protecting the Federal Workforce and Requiring Mask-Wearing; Executive Order 14043, Requiring Coronavirus Disease 2019 Vaccination for Federal Employees; OMB Memorandum M 21-15, COVID-19 Safe Federal Workplace: Agency Model Safety Principles (Jan. 24, 2021), as amended; and the National Defense Authorization Act For Fiscal Year 2017 (5 U.S.C. 6329c(b)). Information will be collected and maintained in accordance with the Rehabilitation Act of 1973 (29 U.S.C. 791
et seq.).
Total Annual Burden:
35 hours.
Total Annual Cost:
No Cost.
Privacy Act Impact Assessment:
Yes. Health information collected about FCC staff and visitors to a FCC facility, which may include immunization and vaccination information, is covered by the FCC's Systems of Records Notice (SORN) OMD-33, Ensuring Workplace Health and Safety in Response to a Public Health Emergency, posted at
https://www.fcc.gov/sites/default/files/sor-fcc-omd-33.pdf.
This system is part of the FCC's ServiceNow platform, which has a Privacy Impact Assessment (PIA) posted at
https://www.fcc.gov/sites/default/files/servicenow-pia-10292019.pdf.
Nature and Extent of Confidentiality:
As Privacy Act-protected records, these records are kept confidential and will not be disclosed except under applicable Privacy Act exceptions, including the routine uses identified in the FCC/OMD-3 SORN.
Needs and Uses:
On September 9, 2021, President Biden issued Executive Order 14043 to protect the health and safety of the Federal workforce and to promote the efficiency of the civil service. Pursuant to the Executive Order and implementing guidance, the Federal Communications Commission (FCC) informed its workforce that, other than in limited circumstances where a reasonable accommodation is legally required, all employees needed to be fully vaccinated against COVID-19 by November 22, 2021, regardless of where they are working. To ensure compliance with this mandate, the FCC established a requirement for employees to complete and submit a form attesting to their current vaccination status. Although the vaccination requirement issued pursuant to E.O. 14043 is currently the subject of a nationwide injunction, the FCC will continue to develop and implement health and safety protocols to ensure and maintain the safety of all occupants during standard operations and public health emergencies or similar health and safety incidents, such as the current pandemic, and will continue to request that workers report on their vaccination status. For some special categories of individuals who perform (or will perform) work for the agency but are not considered employees, the FCC is required to obtain OMB approval prior to collecting such information. These include incoming employees, unpaid interns, unpaid legal fellows, individuals performing work for the FCC pursuant to an Intergovernmental Personnel Agreement, participants in advisory committees, and possibly other similar classes of individuals who are not on the FCC payroll but are performing work for the agency.
Federal Communications Commission.
Katura Jackson,
Federal Register Liaison Officer.