OSHA's Conflict of Interest (COI) and Disclosure Form

Occupational Safety and Health Administration Conflict of Interest and Disclosure Form

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1218-0255 can be found here:

Documents and Forms

Document Name Document Type
Form OSHA Form 10-80.1 OSHA's Conflict of Interest (COI) and Disclosure Form Form
OSHA Form 10-80.1 COI Short Form COI_Short_Form_rev_032307[1](12-31-2013).doc Form
OSHA Form 10-80.2 COI Long Form COI_Long_Form_rev_12-31-2013.doc Form

Information Collection (IC) Details

IC Title:	OSHA's Conflict of Interest (COI) and Disclosure Form	Agency IC Tracking Number:	1218-0255(2013)

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	OSHA Form 10-80.1	COI Short Form	COI_Short_Form_rev_032307[1](12-31-2013).doc		No		Paper Only
Form	OSHA Form 10-80.2	COI Long Form	COI_Long_Form_rev_12-31-2013.doc		No		Paper Only

Line of Business: Workforce Management

Subfunction: Training and Employment

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 36	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Previously Approved
Annual Number of Responses for this IC	36	36
Annual IC Time Burden (Hours)	27	27
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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.