Information Collection

Occupational Safety and Health Program Evaluation Survey Year1

IC 202831 under ICR 201206-0920-005 · OMB 0920-0949.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0949 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Occupational Safety and Health Program Evaluation Survey Year1	Form and Instruction
Occupational Safety and Health Program Evaluation Survey Attachment H-1Year 1 Survey 5_08_12.docx	Form and Instruction
Occupational Safety and Health Program Evaluation Survey Attachment H-2 Year 2 Survey 5_08_12.docx	Form and Instruction

IC Title:

Occupational Safety and Health Program Evaluation Survey Year1

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

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
Form and Instruction	None	Occupational Safety and Health Program Evaluation Survey Year 1	Attachment H-1Year 1 Survey 5_08_12.docx		Yes	Yes	Fillable Fileable
Form and Instruction	None	Occupational Safety and Health Program Evaluation Survey Year 2	Attachment H-2 Year 2 Survey 5_08_12.docx		Yes	Yes	Fillable Fileable

Line of Business: Workforce Management

Subfunction: Training and Employment

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 4,404

Number of Respondents for Small Entity: 3,083

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 95 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	4,404	4,404
Annual IC Time Burden (Hours)	1,468	1,468
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.