OSHA/171 Grantee Quarterly Progress Report

Grantee Quarterly Progress Report

U.S. DEPARTMENT OF LABOR
Occupational Safety and Health Administration

1. GRANTEE NAME

2. GRANT NUMBER

3. REPORTING PERIOD
From:
To:

TRAINING SESSIONS
NUMBER IN ATTENDANCE
4. DATE

CONTACT HOURS

5. LOCATION
6. EMPLOYEES

11. TOTAL FOR REPORTING PERIOD

0

7. EMPLOYERS

0

8. TOTAL

9. CLASS LENGTH
(in quarter hours)

10. TOTAL

0

0.00

12. PLAN FOR QUARTER
13. PERCENT OF PLAN ACCOMPLISHED
14. GRANTEE SIGNATURE

15. DATE

(Name of the Project Director. Submit via Project Director's email.)
INSTRUCTIONS
Instructions for the Grantee Quarterly Progress Report (OSHA 171 and Narrative Report) are contained on the reverse of this form.
RETURN THE COMPLETED FORM TO THE OSHA REGIONAL OFFICE ADMINISTERING YOUR GRANT.
PAPERWORK REDUCTION ACT NOTICE
Form Approved. OMB No. 1218-0100 Expires (Date).
Persons are not required to respond to the collection of information unless it displays a currently valid OMB control number. This information is
being collected so that OSHA can monitor grantee progress in meeting grant workplans, to evaluate the overall effectiveness of the grant program,
and, when applicable, to be used as one factor in determining continued funding of the grant. The grant program provides training for employers
and employees in the recognition, avoidance, and prevention of unsafe and unhealthful working conditions in accordance with Section 21(c) of the
Occupational Safety and Health Act. This collection of information is required to obtain or retain a benefit (29 CFR 95.51 (b) and (d)). This
collection of information is not confidential. We estimate it will take an average of 14 hours to complete this information collection, including time
for reviewing instructions, searching existing datasources, gathering and maintaining data needed, and completing and reviewing the collection
of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for
reducing this burden, to the Directorate of Training and Education, 2020 S. Arlington Heights Road, Arlington Heights, IL 60005, and/or to the
Department of Labor, Office of IRM Policy, Room N-1301, 100 Constitution Avenue, NW, Washington, DC 20210.
Previous editions may not be used

OSHA 171 Revised (Date)