Recordkeeping and Reporting Occupational Injuries and Illnesses (29 CFR Part 1904)

Forms and Documents

Document Name	Status
Form OSHA 6-40.1 Reporting Occupational Injuries and Illnesses Form and Instruction	Modified
Form OSHA 300 Recordkeeping Occupational Injuries and Illnesses (29 CFR Part 1904) Form	Unchanged
Nonsubstantive change -Addition_PRA_webmail_box.rtf Justification for No Material/Nonsubstantive Change	2016-03-04
Note To Reviewer.docx Justification for No Material/Nonsubstantive Change	2015-03-09
ss~NAICS Update and Reporting Reivisoins Final 8-4-2014.doc Supporting Statement A	2014-08-05
29 CFR Part 1904.pdf Supplementary Document	2008-01-16
29 USC 673 Sec 24.pdf Supplementary Document	2008-01-16
29 USC 657 Sec 8.pdf Supplementary Document	2008-01-15

IC Document Collections

IC ID	Document Title	Status
212582	Reporting Occupational Injuries and Illnesses Form and Instruction	Modified
14117	Recordkeeping Occupational Injuries and Illnesses (29 CFR Part 1904) Form	Unchanged

ICR Details

OMB Control No: 1218-0176	ICR Reference No: 201602-1218-002
Status: Historical Active	Previous ICR Reference No: 201502-1218-004
Agency/Subagency: DOL/OSHA	Agency Tracking No: 1218-0176(2014 NAICS )
Title: Recordkeeping and Reporting Occupational Injuries and Illnesses (29 CFR Part 1904)
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 03/08/2016
	Date Received in OIRA: 03/07/2016
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	01/31/2018	01/31/2018	01/31/2018
Responses	6,531,851	0	6,531,851
Time Burden (Hours)	3,101,689	0	3,101,689
Cost Burden (Dollars)	0	0	0

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Abstract: OSHA is revising the burden hour box on the Serious Event Reporting Online form to include an email address, [email protected]. This allows the public another option to submit their comments on the Serious Event Reporting Online form.

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Authorizing Statute(s): US Code: 29 USC 673 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:
1218-AC50	Final or interim final rulemaking	79 FR 56130	09/18/2014

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	75 FR 36414	06/22/2011
30-day Notice:	Federal Register Citation:	Citation Date:
	79 FR 30654	05/28/2014
Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 2

IC Title	Form No.	Form Name
Reporting Occupational Injuries and Illnesses	OSHA 6-40.1	Serious Event Reporting Online Form
Recordkeeping Occupational Injuries and Illnesses (29 CFR Part 1904)	OSHA 6-40.1, OSHA-300A (Spreadsheet Version), OSHA Form 301, OSHA 300, OSHA 300A	Log of Work Related Injuries and Illnesses ,   Injury and Illness Incident Report ,   Summary of Work-Related Injuries and Ilnesses ,   Summary of Work-Related Injuries and Illnesses ,   Serious Event Reporting Portal

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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	6,531,851	6,531,851	0	0	0	0
Annual Time Burden (Hours)	3,101,689	3,101,689	0	0	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	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:

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Annual Cost to Federal Government: $1,326,803

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: 03/07/2016

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