[Federal Register Volume 76, Number 250 (Thursday, December 29, 2011)]
[Page 81999]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2011-33505]



Submission for Review: Certificate of Medical Examination

AGENCY: U.S. Office of Personnel Management.

ACTION: Notice and request for comments.


SUMMARY: The U.S. Office of Personnel Management (OPM) offers the 
general public and other Federal agencies the opportunity to comment on 
an extension without change of a currently approved collection, 
information collection request (ICR) 3206-0250, Certificate of Medical 

DATES: Comments are encouraged and will be accepted until February 27, 
2012. This process is conducted in accordance with 5 CFR 1320.1.

ADDRESS: Interested persons are invited to submit written comments on 
the proposed information collection to Employee Services, U.S. Office 
of Personnel Management, 1900 E Street NW., Washington, DC 20415, 
Attention: Susan Spannbauer or via electronic mail to 
[email protected] or [email protected].

FOR FURTHER INFORMATION CONTACT: A copy of this ICR, with applicable 
supporting documentation, may be obtained by contacting Hiring Policy, 
U.S. Office of Personnel Management, 1900 E Street NW., Washington, DC 
20415, Attention: Susan Spannbauer or via electronic mail to 
[email protected] or [email protected].

SUPPLEMENTARY INFORMATION: The Optional Form (OF) 178, Certificate of 
Medical Examination, is used to collect medical information about 
individuals who are incumbents of positions which require physical 
fitness/agility testing and/or medical examinations, or who have been 
selected for such a position contingent upon meeting physical fitness/
agility testing and medical examinations as a condition of employment. 
This information is needed to ensure fair and consistent treatment of 
employees and job applicants, to adjudicate the medically-based 
passover of a preference eligible, and to adjudicate claims of 
discrimination under the Americans with Disabilities Act (ADA).
    As required by the Paperwork Reduction Act of 1995 (Pub. L. 104-13, 
44 U.S.C. chapter 35) as amended by the Clinger-Cohen Act (Pub. L. 104-
106), OPM is soliciting comments for this collection to:
    1. Evaluate whether the proposed collection of information is 
necessary for the proper performance of the functions of the agency, 
including whether the information will have practical utility;
    2. Evaluate the accuracy of the agency's estimate of the burden of 
the proposed collection of information, including the validity of the 
methodology and assumptions used;
    3. Enhance the quality, utility, and clarity of the information to 
be collected; and
    4. Minimize the burden of the collection of information on those 
who are to respond, including through the use of appropriate automated, 
electronic, mechanical, or other technological collection techniques or 
other forms of information technology, e.g., permitting electronic 
submissions of responses.


    Agency: Employee Services, U.S. Office of Personnel Management.
    Title: Certificate of Medical Examination.
    OMB Number: 3206-0250.
    Affected Public: Federal Government.
    Number of Respondents: 45,000.
    Estimated Time per Respondent: 3 hours.
    Total Burden Hours: 135,000 hours.

U.S. Office of Personnel Management.
John Berry,
[FR Doc. 2011-33505 Filed 12-28-11; 8:45 am]