Information Collection

Voluntary Protection Program, Special Government Employee

IC 14302 under ICR 201409-1218-003 · OMB 1218-0239.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1218-0239 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
VPP Application Instructions - CORPORATE Final 2014.doc www.osha.gov/dcsp/vpp/application_corporate.html	Instruction
VPP Application Instructions - MOBILE WORKFORCE Final 2014.doc www.osha.gov/dcsp/vpp/application_mobile_workforce.html	Instruction
VPP Application Instructions SITE-BASED Final 09_18_14.doc www.osha.gov/dcsp/vpp/application_sitebased.html	Instruction
VPP _Application_ PSM_Sites_ Supplement _A (2014).doc www.osha.gov/dcsp/vpp/psmfinal2014.html	Instruction
PSM Supplement B 2013 - Participant Worksheet FINAL (2014).docx	Instruction
2012 VPP participant self eval - (2014).doc	Instruction
SGE Application Screen Fillable (2014).doc www.osha.gov/dcsp/vpp/sge/sge_application.pdf	Instruction
Site-Based Participation Evaluation Report.docx www.osha.gov/dcsp/vpp/vpp_report/site_based.pdf	Instruction
Mobile Workforce Participation Evaluation Report.doc www.osha.gov/dcsp/vpp/vpp_report/mobile_workforce.pdf	Instruction
Corporate Reapproval or Facility onsite Process Evaluation Report.doc www.osha.gov/dcsp/vpp/process_template.pdf	Instruction
PSM Supplemental Questions Supplement C.doc	Instruction
Supplement C-- PSM Questions.doc	Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

Voluntary Protection Program, Special Government Employee

Agency IC Tracking Number:

1218-0239(2014)

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Instruction	VPP Application Instructions - CORPORATE Final 2014.doc	http://www.osha.gov/dcsp/vpp/application_corporate.html	Yes	Yes	Fillable Fileable
Instruction	VPP Application Instructions - MOBILE WORKFORCE Final 2014.doc	http://www.osha.gov/dcsp/vpp/application_mobile_workforce.html	Yes	Yes	Fillable Printable
Instruction	VPP Application Instructions SITE-BASED Final 09_18_14.doc	http://www.osha.gov/dcsp/vpp/application_sitebased.html	Yes	Yes	Fillable Printable
Instruction	VPP _Application_ PSM_Sites_ Supplement _A (2014).doc	https://www.osha.gov/dcsp/vpp/psmfinal2014.html	Yes	Yes	Printable Only
Instruction	PSM Supplement B 2013 - Participant Worksheet FINAL (2014).docx		No		Printable Only
Instruction	2012 VPP participant self eval - (2014).doc		No		Printable Only
Instruction	SGE Application Screen Fillable (2014).doc	https://www.osha.gov/dcsp/vpp/sge/sge_application.pdf	Yes	Yes	Fillable Printable
Instruction	Site-Based Participation Evaluation Report.docx	https://www.osha.gov/dcsp/vpp/vpp_report/site_based.pdf	Yes	Yes	Fillable Printable
Instruction	Mobile Workforce Participation Evaluation Report.doc	https://www.osha.gov/dcsp/vpp/vpp_report/mobile_workforce.pdf	Yes	Yes	Fillable Fileable
Instruction	Corporate Reapproval or Facility onsite Process Evaluation Report.doc	https://www.osha.gov/dcsp/vpp/process_template.pdf	Yes	Yes	Fillable Fileable
Instruction	PSM Supplemental Questions Supplement C.doc		No		Paper Only
Instruction	Supplement C-- PSM Questions.doc		No		Paper Only

Federal Enterprise Architecture Business Reference Module

Line of Business: Workforce Management

Subfunction: Worker Safety

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 2,300

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 10 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	3,815	0	-440	4,255
Annual IC Time Burden (Hours)	114,150	-1,220	11	115,359
Annual IC Cost Burden (Dollars)	0	0	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.