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Form request religious exemption 2026

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The document is a request form for DoD civilian employees seeking a religious exemption from the COVID-19 vaccination requirement. It outlines the legal authority for collecting information, the purpose of the request, and the consequences of not providing information. Employees must describe their religious beliefs and how these beliefs conflict with the vaccination requirement. The form also includes instructions for completion and emphasizes that any misrepresentation may lead to legal consequences.

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Click ‘Get Form’ to open it in the editor.
Begin by filling in your personal details, including your name, DoD ID number, office symbol, and date of request. Ensure accuracy as this information is crucial for processing your exemption.
In sections 8 to 11, provide detailed narratives about your religious beliefs and practices. Clearly articulate how these beliefs conflict with the COVID-19 vaccination requirement.
If applicable, answer questions 12.a through 12.c regarding any previous objections to vaccinations based on religious beliefs. Provide thorough explanations to support your request.
Use section 13 to include any additional information that may assist in evaluating your request. Attach supporting documentation if necessary.
Finally, review all entries for accuracy before signing and dating the form at sections 15 and 16.

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2021	4.9 Satisfied (54 Votes)

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3177 religious exemption

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