Form BLS 9300 IDCF BLS 9300 IDCF 1st Mailing (non DJTR)

DISTRICT OF COLUMBIA DEPARTMENT OF LABOR
PO BOX 303500
LINE 2
MONTGOMERY, AL 36130-3500

U.S. Department of Labor
Bureau of Labor Statistics
For Help
Call:

334-242-3462
334-242-3463
Fax: 334-242-3333

2011 Establishment ID:

01-203479880-1
Account Number:

Report for:
The Unit Description goes here

302203479880

Temporary Password:

ANSu5155

NAICS: 512110 - Motion Picture and Video Production
Employment

12345

ownership code 50

PRIMARY COMPANY NAME
{SECONDARY COMPANY NAME}
ADDRESS LINE 1
ADDRESS LINE 2
CITY, STATE ZIP-PLUS+4
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FINAL NOTICE
RESPONSE REQUIRED IMMEDIATELY
MANDATORY REPORT – DATED MATERIAL
U.S. GOVERNMENT DOCUMENTS ENCLOSED

Instructions for Completing the
2011 Survey of Occupational Injuries and Illnesses
YOUR PARTICIPATION IS REQUIRED BY LAW.
Options to Report Your Data
If you receive multiple forms, please check the account numbers and establishment IDs
as you may have more than one establishment to report.

Option 1: Report your data through the Internet Data Collection Facility (IDCF) on the
Bureau of Labor Statistics (BLS) website: https://idcf.bls.gov
Option 2:

Request an electronic fillable form of the survey by sending an e-mail to:

[email protected]
We estimate it will take you an average of 24 minutes to complete this survey (ranging from 10 minutes to 5 hours per package), including time
for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing this
information. If you have any comments regarding the estimates or any other aspect of this survey, including suggestions for reducing this
burden, please send them to the Bureau of Labor Statistics, Occupational Safety and Health Statistics (1220-0045), 2 Massachusetts Avenue,
N.E., Washington, DC 20212. Persons are not required to respond to the collection of information unless it displays a currently valid OMB
control number. DO NOT SEND THE COMPLETED FORM TO THIS ADDRESS.
The Bureau of Labor Statistics, its employees, agents, and partner statistical agencies, will use the information you provide
for statistical purposes only and will hold the information in confidence to the full extent permitted by law. In accordance
with the Confidential Information Protection and Statistical Efficiency Act of 2002 (Title 5 of Public Law 107-347) and
other applicable Federal laws, your responses will not be disclosed in identifiable form without your informed consent.

OMB No. 1220-0045
BLS-9300-IDCF

Under Public Law 91-596, all establishments that receive this survey must complete and return it within 30 days, even if they had no workrelated injuries and illnesses during 2011.

In December 2010, you were notified of your participation in the BLS 2011 Survey of Occupational Injuries and Illnesses (SOII) and
asked to maintain records of workplace injuries and illnesses throughout 2011.

Forms to help you complete the survey
(NOTE: If you did not record the necessary information on your OSHA forms, please use whatever records you have available.)

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OSHA’s Form 300 - Log of Work-Related Injuries and Illnesses; includes all injuries and illnesses for the year
OSHA’s Form 300A - Summary of Work-Related Injuries and Illnesses; includes average employment and total hours worked
OSHA’s Form 301 - Injury and Illness Incident Report; includes detailed injury and illness data
State Worker’s Compensation Forms

Use the BLS Internet Data Collection Facility
Before reporting your data, you must register with the BLS even if you have registered in previous years or for other surveys. Please
do not register unless you will be the one completing the survey.
1. Go to https://idcf.bls.gov on your internet browser. The “s” in “https” is required.
2. Enter the 12-digit Account Number in the field labeled “Account Number” and the Temporary Password in the field labeled
“Password”. Click I Accept.
U.S. Department of Labor
Bureau of Labor Statistics

For Help
Call: 334-242-3462
334-242-1000
Fax: 334-242-3333

Example
You will need your account number
and temporary password if you
report using the internet.

Account Number:
302203479880
Temporary Password:
ANSu5155

NAICS: 512110 - Motion Picture and Video Production
Los Angeles, CA

Your NAICS

3. Complete the “Check E-mail Address”, “Enter New User Information” and “Create a Permanent Password” pages.
4. Click Continue on the “Confirmation Notice” page.
5. Report your data and click Submit when you are finished. Print a copy of the completed survey for your records.
6. You may log onto the website using your account number and permanent password at any time to make corrections to your data.
You can report for additional establishment IDs by logging into the survey again, clicking the Continue arrow on the “Dear
Employer” page, and adding the establishment ID on the “Add New Establishment(s) to Account” page.
For alternate reporting methods, please contact your state office at the telephone number listed under “For Help” on the front page.

Need help?
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


For step-by-step website registration instructions or website technical help, go to http://www.bls.gov/idcf/instructions.htm.
For questions about this survey, contact us using the telephone number(s) listed on the front of this form.
For information about SOII, including frequently asked questions and to download forms, go to
http://www.bls.gov/respondents/iif/.

To see how your data will be used, please visit our website at http://www.bls.gov/iif.