Student Data Form

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form 182 Student Data Form	Form	Modified	Available
29CFR1949.pdf	Supplementary Document	Uploaded 2010-09-20	Available
Circular No. A-25 -- User Charges.pdf	Supplementary Document	Uploaded 2010-09-20	Available
Title 31 U.S.C. 9701.pdf	Supplementary Document	Uploaded 2010-09-20	Available
SEC 21.pdf	Supplementary Document	Uploaded 2010-09-20	Available
SS_1218-0172 Final (09-20-2010).pdf	Supporting Statement A	Uploaded 2010-09-20	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
14106	Student Data Form	Form	Modified

ICR Details

OMB Control No: 1218-0172	ICR Reference No: 201009-1218-001
Status: Historical Active	Previous ICR Reference No: 200708-1218-001
Agency/Subagency: DOL/OSHA	Agency Tracking No: 1218-0172(2010)
Title: Student Data Form
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 12/08/2010
	Date Received in OIRA: 10/29/2010
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	12/31/2013	36 Months From Approved	12/31/2010
Responses	2,000	0	2,000
Time Burden (Hours)	160	0	167
Cost Burden (Dollars)	0	0	0

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Abstract: OSHA Form 182 is used to collect student group and emergency contact information from OSHA Training Institute students. The collected information is used to contact a designated person in case of an emergency. Student group data is used for reports, and tuition receipts.

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Authorizing Statute(s): US Code: 29 USC 670 Name of Law: Occupational Safety and Health Act
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	75 FR 39279	07/08/2010
30-day Notice:	Federal Register Citation:	Citation Date:
	75 FR 66793	10/29/2010
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

table that charts list of burden

IC Title	Form No.	Form Name
Student Data Form	182	Student Data Form

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ICR Summary of Burden

table that charts list of burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	2,000	2,000	0	0	0	0
Annual Time Burden (Hours)	160	167	0	0	-7	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: The Agency is requesting a 7 hour burden adjustment decrease (from 167 burden hours to 160 burden hours). The decrease is a result of standardizing the 5 minute time estimate used for students to complete the SDF (i.e., 2,000 forms x .08 hour = 160 burden hours rather than 2,000 forms x 5 minutes/60 = 167 hours) to conform with the five minute time estimates used in other Agency Information Collection Requests.

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Annual Cost to Federal Government: $8,332

Does this IC contain surveys, censuses, or employ statistical methods? No

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 10/29/2010

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