Information Collection

Occupational Safety and Health Variance Regulation

IC 199154 under ICR 201501-1218-003 · OMB 1218-0265.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1218-0265 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
oshaform5-30-1a.pdf	Instruction
oshaform5-30-2a.pdf	Instruction
oshaform5-30-3a.pdf	Instruction
oshaform5-30-4a.pdf	Instruction
OSHA Form5-30-1 Experimental Variance Application OSHAForm5-30-1.pdf www.osha.gov/dts/otpca/variances/experimental_variance_app_form.pdf	Form
OSHA Form 5-30-2 Temporary Variance Application OSHAForm5-30-2.pdf www.osha.gov/dts/otpca/variances/temp_variance_app_form.pdf	Form
OSHA Form 5-30-3 Permanent Variance Application OSHAForm5-30-3.pdf www.osha.gov/dts/otpca/variances/permanent_variance_app_form.pdf	Form
OSHA Form 5-30-4 National Defense Variance Application OSHAForm5-30-4.pdf www.osha.gov/dts/otpca/variances/national_defence_variance_app_form.pdf	Form

IC Title:

Occupational Safety and Health Variance Regulation

Agency IC Tracking Number:

Is this a Common Form? Yes

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 29 CFR Part 1905 (To search for a specific CFR, visit the Code of Federal Regulations.)

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Instruction			oshaform5-30-1a.pdf		Yes	No	Printable Only
Instruction			oshaform5-30-2a.pdf		Yes	No	Printable Only
Instruction			oshaform5-30-3a.pdf		Yes	No	Printable Only
Instruction			oshaform5-30-4a.pdf		Yes	No	Printable Only
Form	OSHA Form5-30-1	Experimental Variance Application	OSHAForm5-30-1.pdf	https://www.osha.gov/dts/otpca/variances/experimental_variance_app_form.pdf	Yes	No	Fillable Printable
Form	OSHA Form 5-30-2	Temporary Variance Application	OSHAForm5-30-2.pdf	https://www.osha.gov/dts/otpca/variances/temp_variance_app_form.pdf	Yes	No	Fillable Printable
Form	OSHA Form 5-30-3	Permanent Variance Application	OSHAForm5-30-3.pdf	https://www.osha.gov/dts/otpca/variances/permanent_variance_app_form.pdf	Yes	No	Fillable Printable
Form	OSHA Form 5-30-4	National Defense Variance Application	OSHAForm5-30-4.pdf	https://www.osha.gov/dts/otpca/variances/national_defence_variance_app_form.pdf	Yes	No	Fillable Printable

Line of Business: Workforce Management

Subfunction: Worker Safety

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 12

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	12	12
Annual IC Time Burden (Hours)	366	366
Annual IC Cost Burden (Dollars)	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.