Notice of Alleged Safety and Health Hazards (Form OSHA-7)

Forms and Documents

Document Name	Status
Form OSHA-7 Notice of Alleged Safety or Health Hazards (OSHA-7 Form) Form and Instruction	Modified
30-Day Notice.pdf Supplementary Document	2014-05-30
60 Day Notice.pdf Supplementary Document	2014-05-30
eCFR 1903.11.docx Supplementary Document	2014-05-30
29 USC 657.docx Supplementary Document	2014-05-30
29 USC 651.docx Supplementary Document	2014-05-30
SS 1218-0064 05302014 Final.docx Supporting Statement A	2014-05-30

IC Document Collections

IC ID	Document Title	Status
13971	Notice of Alleged Safety or Health Hazards (OSHA-7 Form) Form and Instruction	Modified

ICR Details

OMB Control No: 1218-0064	ICR Reference No: 201405-1218-001
Status: Historical Active	Previous ICR Reference No: 201107-1218-001
Agency/Subagency: DOL/OSHA	Agency Tracking No: 1218-0064(2014) (Rev)
Title: Notice of Alleged Safety and Health Hazards (Form OSHA-7)
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 08/29/2014
	Date Received in OIRA: 05/30/2014
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	08/31/2017	36 Months From Approved	08/31/2014
Responses	50,641	0	50,715
Time Burden (Hours)	13,659	0	13,414
Cost Burden (Dollars)	13,659	0	1,116

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Abstract: The OSHA-7 Form is used by OSHA personnel to report unhealthful and/or unsafe conditions in the workplace. The information is given to OSHA by employees who wish to report unhealthful and/or unsafe conditions at their place of employment. Employee reports are authorized by Section 8(f)(1) of the OSH Act. This information is used by OSHA to evaluate the alleged hazards and to schedule an inspection. The form is available in English and Spanish.

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Authorizing Statute(s): US Code: 29 USC 651 Name of Law: Occupational Safety and Health Act
   US Code: 29 USC 657 Name of Law: Occupational Safety and Health Act
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	79 FR 4180	01/24/2014
30-day Notice:	Federal Register Citation:	Citation Date:
	79 FR 30897	05/29/2014
Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
Notice of Alleged Safety or Health Hazards (OSHA-7 Form)	OSHA-7, OSHA-& On-Line	Notice of Alleged Safety or Health Hazards ,   OSHA Online Complaint Form-Notice of Alleged Safety or Health Hazards

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ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	50,641	50,715	0	0	-74	0
Annual Time Burden (Hours)	13,659	13,414	0	0	245	0
Annual Cost Burden (Dollars)	13,659	1,116	0	0	12,543	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: The Agency is requesting an adjustment increase of 245 burden hours (from 13,414 to 13,659). While, there was a decrease in the estimated number of complaints, processed from 50,715 to 50,641, there was an increase in the number of complaints being submitted on-line electronically, from 10,143 forms to 26,473 forms. The estimated time to submit an OSHA-7 Form electronically is two minutes longer than complainants to submit information orally. As a result, there is a 245 hour increase though the number of OSHA-7 forms decreased. There was an overall decrease in cost from $1,116 to $532. The decrease occurred due to a decrease in the estimated number of paper OSHA-7 forms being received from 2,536 to 1,208 forms.

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Annual Cost to Federal Government: $223,996

Does this IC contain surveys, censuses, or employ statistical methods? No

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 05/30/2014

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