BLS 9300 2012 Pre-Note Leaflet

U.S. Department of Labor
Bureau of Labor Statistics

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

For Help
Call:

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

2012 Establishment ID:

01-203479880

Report for:
The Unit Description goes here

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
MANDATORY REPORT – DATED MATERIAL
U.S. GOVERNMENT DOCUMENTS ENCLOSED

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Notice of Recordkeeping Requirements for the
2012 Survey of Occupational Injuries and Illnesses
YOUR PARTICIPATION IS REQUIRED BY LAW

Important
 Maintain the information required for all recordable work-related injuries and illnesses
that occur between January 1 and December 31, 2012, for the establishment(s) identified
above.
 Visit our respondents’ page at
for more information about
the Bureau of Labor Statistics Survey of Occupational Injuries and Illnesses (SOII) and
your recordkeeping requirements.
 Keep these records and use them to complete the Survey of Occupational Injuries and
Illnesses. We will send you more instructions in January 2013.
 If you need help, please contact us at the phone number(s) listed above.

Overview of Your Recordkeeping Requirements


You must maintain the information required for all recordable work-related injuries and illnesses that
occur during calendar year 2012 for the establishment(s) identified on the front.



The enclosed OSHA Forms for Recording Work-Related Injuries and Illnesses provide instructions
for filling out the Log of Work-Related Injuries and Illnesses (OSHA Form 300) and the Injury and
Illness Incident Report (OSHA Form 301). In addition, please keep records on the race and/or
ethnicity of your injured or ill workers. This information will be requested in January 2013.



At the end of 2012, complete the enclosed Summary of Work-Related Injuries and Illnesses
(OSHA Form 300A) even if you had NO work-related injuries or illnesses.



In January 2013, you will be mailed instructions for completing the Survey of Occupational
Injuries and Illnesses.



If you have any questions about your record-keeping requirements for this survey, or if you need
help, call the phone number(s) on the front of this form.

How Your Injury and Illness Data Are Used
Your data are important for making American workplaces safer. Data you report are aggregated with data
from other establishments and used to identify injury and illness patterns among industries and occupations.
For more information about injury and illness statistics, please visit our website at
.