{"id":"SEC-12-077","kind":"order","level":"federal","jurisdiction":"United States","state":"","metro":"","industry":"12","agency":"","eco":"","issuer":"Safer Federal Workforce Task Force / Office of Personnel Management (OMB Control No. 3206-0277)","authority":"Executive Order 13991; 5 U.S.C. § 7301","instrument":"Certification of Vaccination form (PRA version 7)","title":"Certification of Vaccination (federal employees, onsite contractors and visitors)","dateIssued":"2021-07-29","effective":"August 2021","end":"Revised with EO 14043 implementation (post-period)","startDate":"2021-07-29","endDate":"2021-09-30","quarters":["2021Q3"],"types":["VAX","MASK","EMP"],"addressees":["federal employees","onsite contractors","visitors to Federal buildings"],"clause":"I understand that if I decline to respond or am not fully vaccinated, I must comply with [the following]: Wear a mask regardless of the level of community transmission... I am a visitor or I am an onsite contractor who is not enrolled in an agency\u0027s testing program... I sign this document under penalty of perjury","enforcement":"18 U.S.C. § 1001 (false statements); agency administrative action","functions":["CS","DC","BD"],"notes":"The form itself states the rule imposed on onsite contractors and visitors","sourceUrl":"https://www.saferfederalworkforce.gov/downloads/CertificationVaccinationPRAv7.pdf","snapshot":"http://web.archive.org/web/20210806200423/https://www.saferfederalworkforce.gov/downloads/CertificationVaccinationPRAv7.pdf","fileExists":true,"fileBytes":862191,"grade":"primary","character":"","description":"","collection":"SEC-12","url":"/library/SEC-12-077","exhibitUrl":"/exhibit/SEC-12-077","citation":"Safer Federal Workforce Task Force / Office of Personnel Management (OMB Control No. 3206-0277), Certification of Vaccination form (PRA version 7) (July 29, 2021) (Ex. SEC-12-077)","stateName":"","related":["SEC-12-011","SEC-12-075"]}