# Submission for OMB Review; Comment Request
**AGENCY:**
The Office of the Assistant Secretary of Defense for Health Affairs, Department of Defense (DoD).
**ACTION:**
30-Day information collection notice.
**SUMMARY:**
The Department of Defense has submitted to OMB for clearance the following proposal for collection of information under the provisions of the Paperwork Reduction Act.
**DATES:**
Consideration will be given to all comments received by July 26, 2021.
**ADDRESSES:**
Written comments and recommendations for the proposed information collection should be sent within 30 days of publication of this notice to *www.reginfo.gov/public/do/PRAMain.* Find this particular information collection by selecting “Currently under 30-day Review—Open for Public Comments” or by using the search function.
**FOR FURTHER INFORMATION CONTACT:**
Angela Duncan, 571-372-7574, or *[email protected].*
**SUPPLEMENTARY INFORMATION:**
*Title; Associated Form; and OMB Number:* COVID-19 Vaccine Screening and Immunization Documentation; DHA Form 207; OMB Control Number 0720-0068.
*Type of Request:* Revision.
*Number of Respondents:* 2,000,000.
*Responses per Respondent:* 2.
*Annual Responses:* 4,000,000.
*Average Burden per Response:* 5 minutes.
*Annual Burden Hours:* 333,333.34.
*Needs and Uses:* The Defense Health Agency (DHA) has created the DHA Form 207, “COVID-19 Vaccine Screening and Immunization Documentation” to determine if the COVID-19 vaccine can be administered to a patient. The DHA Form 207 is used to determine and document patient eligibility and vaccine declinations for a COVID-19 vaccination. Respondents include Active Duty military members, Federal employees, beneficiaries, and contractors (based on their employment) who wish to receive the vaccine.
*Affected Public:* Individuals or households.
*Frequency:* On occasion.
*Respondent's Obligation:* Voluntary.
*OMB Desk Officer:* Dr. James Crowe.
You may also submit comments and recommendations, identified by Docket ID number and title, by the following method:
• *Federal eRulemaking Portal: http://www.regulations.gov.* Follow the instructions for submitting comments.
*Instructions:* All submissions received must include the agency name, Docket ID number, and title for this *Federal Register* document. The general policy for comments and other submissions from members of the public is to make these submissions available for public viewing on the internet at *http://www.regulations.gov* as they are received without change, including any personal identifiers or contact information.
*DOD Clearance Officer:* Ms. Angela Duncan.
Requests for copies of the information collection proposal should be sent to Ms. Duncan at *[email protected].*
Dated: June 16, 2021.
Aaron T. Siegel,
Alternate OSD Federal Register Liaison Officer, Department of Defense.