Information Collection

Regulations Containing Procedures for Handling of Retaliation Complaints

IC 14293 under ICR 201604-1218-001 · OMB 1218-0236.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1218-0236 can be found here:

2025-01-14 - No material or nonsubstantive change to a currently approved collection
2024-05-08 - No material or nonsubstantive change to a currently approved collection

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
File A Complaint_Screenshot_English-4-22-16.docx www.whistleblowers.gov/complaint_page.html	Other-Web page
File A Complaint_Screenshot_Spanish-4-22-16.docx www.whistleblowers.gov/complaint_page.html	Other-Web page
whistleblower_acts-desk_reference_English 4-22-16.pdf www.whistleblowers.gov/whistleblower_acts-desk_reference.pdf	Other-Web page
Whistleblower-online complaint form - worker protections screenshots.docx www.whistleblowers.gov/wb_filing_time_limits.html	Other-null
OSHA 8-60.1 Notice of Whistleblower Complaint Whistleblower-OnlineComplaintForm-FullScreens-English-05-02-16.docx www.whistleblowers.gov/complaint_page.html	Form and Instruction
OSHA 8-60.1 Formulario Electronico de la OSHA Para Presentar Queja C Whistleblower-OnlineComplaintForm-FullScreens-Spanish-05-02-16.docx www.whistleblowers.gov/complaint_page_sp.html	Form and Instruction
1218-0236 IC Supplementary Statement 06-08-16 (2).docx Supplementary Explanation of Revised Form	IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

Regulations Containing Procedures for Handling of Retaliation Complaints

Agency IC Tracking Number:

1218-0236(2016)

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation: 29 CFR 1982 29 CFR 1988 29 CFR 1979 29 CFR 1977 29 CFR 1983 29 CFR 1984 29 CFR 1981 29 CFR 1986 29 CFR 1980 29 CFR 1985 29 CFR 1978 29 CFR 1987 29 CFR 24

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
Other-Web page			File A Complaint_Screenshot_English-4-22-16.docx	http://www.whistleblowers.gov/complaint_page.html	Yes	No	Printable Only
Other-Web page			whistleblower_acts-desk_reference_English 4-22-16.pdf	http://www.whistleblowers.gov/whistleblower_acts-desk_reference.pdf	Yes	No	Printable Only
Form and Instruction	OSHA 8-60.1	Notice of Whistleblower Complaint	Whistleblower-OnlineComplaintForm-FullScreens-English-05-02-16.docx	http://www.whistleblowers.gov/complaint_page.html	Yes	Yes	Fillable Fileable
Form and Instruction	OSHA 8-60.1	Formulario Electronico de la OSHA Para Presentar Queja Como Denunciante	Whistleblower-OnlineComplaintForm-FullScreens-Spanish-05-02-16.docx	http://www.whistleblowers.gov/complaint_page_sp.html	Yes	Yes	Fillable Fileable
Other-null			Whistleblower-online complaint form - worker protections screenshots.docx	http://www.whistleblowers.gov/wb_filing_time_limits.html	Yes	No	Printable Only
Other-Web page			File A Complaint_Screenshot_Spanish-4-22-16.docx	http://www.whistleblowers.gov/complaint_page.html	Yes	No	Printable Only

Federal Enterprise Architecture Business Reference Module

Line of Business: Workforce Management

Subfunction: Worker Safety

Privacy Act System of Records

Title: DOL/OSHA 1, Retaliation Complaint File

FR Citation: 67 FR 16816

Number of Respondents: 7,516

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 50 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	7,516	4,644	2,872
Annual IC Time Burden (Hours)	7,516	4,644	2,872
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Supplementary Explanation of Revised Form	1218-0236 IC Supplementary Statement 06-08-16 (2).docx	06/08/2016

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