# 2026-16307: State Dept Wants Comments on Emergency Selfie Certification Form

2026-16307, 30-Day Notice of Proposed Information Collection: Employee Self-Certification and Ability To Perform in Emergencies (ESCAPE) Posts, Pre-Deployment Physical Exam Acknowledgement Form, is a Federal Register notice from State Department published 2026-08-11, effective Submit comments up to September 10, 2026. (as of 2026-08-18).

- Canonical: https://policyrisk.com/federal-register/2026-16307
- As of: 2026-08-18
- Plain-text twin of the page above; the HTML and this file carry the same facts.

## Facts
- Document number: 2026-16307
- Title: 30-Day Notice of Proposed Information Collection: Employee Self-Certification and Ability To Perform in Emergencies (ESCAPE) Posts, Pre-Deployment Physical Exam Acknowledgement Form
- Type: Notice
- Agencies: State Department
- Citation: 91 FR 51823
- Published: 2026-08-11
- Effective: Submit comments up to September 10, 2026.
- Comments close: 2026-09-10
- Significant: no
- Touches household money: no
- Regulation identifier numbers: none
- Last updated: 2026-08-18

## In one line

State Dept Wants Comments on Emergency Selfie Certification Form

## Summary

The Department of State has submitted the information collection described below to the Office of Management and Budget (OMB) for approval. In accordance with the Paperwork Reduction Act of 1995, we are requesting comments on this collection from all interested individuals and organizations. The purpose of this Notice is to allow 30 days for public comment.

## Effects PRIA read

- DS-6570 Required for ESCAPE Contractors: cost, low. If you are a contractor deploying to an ESCAPE diplomatic post (Iraq, Juba, Kyiv, Libya, Peshawar, Somalia, Syria, or Yemen), you must complete the DS-6570 pre-deployment form annually to request access to the Department of State Medical Program. The agency estimates 3,800 respondents, 1,900 respon…
- DS-6570 Required for Eligible Family Members: cost, low. Eligible family members deploying to ESCAPE diplomatic posts (Iraq, Juba, Kyiv, Libya, Peshawar, Somalia, Syria, or Yemen) must complete the DS-6570 pre-deployment physical exam acknowledgement form annually to request access to the Department of State Medical Program. The Department estimates over…
- Physician Time to Complete DS-6570: cost, low. Non-federal medical providers who complete the DS-6570 for applicants are estimated to spend about 30 minutes per response. The Department revised burden estimates to account for non-federal health care providers and reports an average physician time of 30 minutes per completed form.

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## Sources
- [2026-16307 on federalregister.gov](https://www.federalregister.gov/documents/2026/08/11/2026-16307/30-day-notice-of-proposed-information-collection-employee-self-certification-and-ability-to-perform)
- [2026-16307 as published (PDF)](https://www.govinfo.gov/content/pkg/FR-2026-08-11/pdf/2026-16307.pdf)

## Related
- [Previous: 2026-16306, Midyear Adjustment to the Calendar Year (CY) 2026 Privately Owned Vehicle (POV)…](https://policyrisk.com/federal-register/2026-16306)
- [Next: 2026-16308, Agency Information Collection Activity: Veteran/Servicemembers Supplemental App…](https://policyrisk.com/federal-register/2026-16308)
- [All Federal Register documents](https://policyrisk.com/federal-register)

Source: PRIA, https://policyrisk.com/federal-register/2026-16307 (as of 2026-08-18).