OMB control number
Contractor Personnel and Visitor Certification of Vaccination
OMB 0704-0613 · DOD/DODDEP.
This information is being requested in order to promote the safety of individuals in Federal buildings and on DoD installations, consistent with the COVID-19 Workplace Safety: Agency Model Safety Principles established by the Safer Federal Workforce Task Force and guidance from the CDC and the Occupational Safety and Health Administration. This information will be used by DoD staff charged with implementing and enforcing workplace safety protocols and is required for ensuring compliance with the requirement for attestation by all civilian employees, on-site contractors, and official visitors. Vaccination status for Military Service members will be obtained by alternate means using DoD’s Individual Medical Readiness system.
The latest form for Contractor Personnel and Visitor Certification of Vaccination expires 2026-04-30 and can be found here.
Document Name |
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Form and Instruction |
Supplementary Document |
Supporting Statement A |
Form DD 3150 Contractor Personnel and Visitor Certification of Vaccination
0704-0613_Sample Email_11.23.2021.docx
Contractor Personnel and Visitor Certification of Vaccination |
Approved with change |
Revision of a currently approved collection | 2022-02-25 | |
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Approved with change |
New collection (Request for a new OMB Control Number) | 2021-08-24 |