Quality Assurance Study

Survey of Occupational Injuries and Illnesses

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1220-0045 can be found here:

Documents and Forms

Document Name Document Type
Letter.doc Other-Letter to Respondents
Note to Reviewer (1220-0045) final - undercount survey version 3.doc Note to Reviewer IC Document

Information Collection (IC) Details

IC Title:	Quality Assurance Study	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Removed

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Letter to Respondents			Letter.doc		Yes	Yes	Fillable Fileable

Line of Business: General Government

Subfunction: Central Records & Statistical Mgt

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 3,500	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits, Farms, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 12 %

	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	-3,500	3,500
Annual IC Time Burden (Hours)	-583	583
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Note to Reviewer	Note to Reviewer (1220-0045) final - undercount survey version 3.doc	02/09/2007

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.