Occupational Safety and Health Administration QuickTakes Survey

Department of Labor Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1225-0088 can be found here:

Documents and Forms

Document Name Document Type
QuickTakes Survey Mock-up.pdf Other-Web-based survey
Survey questions.docx Other-Web-based survey
OSHA QT Clearance Template (20140630).docx SupplementalJustification Supporting Statement for Occupational Safety and Health Administration QuickTakes Survey IC Document

Information Collection (IC) Details

IC Title:	Occupational Safety and Health Administration QuickTakes Survey	Agency IC Tracking Number:

IC Status: New

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
Other-Web-based survey			QuickTakes Survey Mock-up.pdf		Yes	Yes	Fillable Fileable
Other-Web-based survey			Survey questions.docx		Yes	Yes	Fillable Fileable

Line of Business: Workforce Management

Subfunction: Worker Safety

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 7,000	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	7,000	7,000
Annual IC Time Burden (Hours)	233	233
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
SupplementalJustification Supporting Statement for Occupational Safety and Health Administration QuickTakes Survey	OSHA QT Clearance Template (20140630).docx	06/30/2014

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.