Information Collection

OSHA Data Initiative (State,Local or Tribal Gov't)

IC 45389 under ICR 200912-1218-012 · OMB 1218-0209.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1218-0209 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
196b2008-notification.pdf	Instruction
OSHA Form 196B OSHA Work-Related Injury and Illness Data Collection For 196b2008-surveyform.pdf www.osha.gov/form196/cy08.htm	Form and Instruction

IC Title:

OSHA Data Initiative (State,Local or Tribal Gov't)

Agency IC Tracking Number:

1218-0209(2009)

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 29 CFR 1904

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Instruction			196b2008-notification.pdf		No		Printable Only
Form and Instruction	OSHA Form 196B	OSHA Work-Related Injury and Illness Data Collection Form	196b2008-surveyform.pdf	http://www.osha.gov/form196/cy08.htm	Yes	Yes	Fillable Fileable

Line of Business: Workforce Management

Subfunction: Worker Safety

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 200

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 75 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	200	200
Annual IC Time Burden (Hours)	33	33
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

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