Notice of Alleged Safety or Health Hazards

Forms and Documents

Document Name	Status
Form OSHA-7 Notice of Alleged Safety or Health Hazards (OSHA-7 Form) Form	Modified
Final Supporting Statement - OSHA 7 Complaint Form (1218-0064) 07.11.17.docx Supporting Statement A	2017-07-11
Preclearance FRN 04.24.17.pdf Supplementary Document	2017-07-06
eCFR 1903.11.docx Supplementary Document	2014-05-30
29 USC 657.docx Supplementary Document	2014-05-30
29 USC 651.docx Supplementary Document	2014-05-30

IC Document Collections

IC ID	Document Title	Status
13971	Notice of Alleged Safety or Health Hazards (OSHA-7 Form) Form	Modified

ICR Details

OMB Control No: 1218-0064	ICR Reference No: 201707-1218-003
Status: Active	Previous ICR Reference No: 201606-1218-001
Agency/Subagency: DOL/OSHA	Agency Tracking No: 1218-0064(2017)
Title: Notice of Alleged Safety or Health Hazards
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 11/03/2017
	Date Received in OIRA: 08/31/2017
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	11/30/2020	36 Months From Approved	11/30/2017
Responses	70,976	0	50,641
Time Burden (Hours)	19,258	0	13,659
Cost Burden (Dollars)	701	0	13,659

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Abstract: The OSHA-7 Form is used by OSHA personnel to report unhealthful and/or unsafe conditions in the workplace. The information is given to OSHA by employees who wish to report unhealthful and/or unsafe conditions at their place of employment. Employee reports are authorized by Section 8(f)(1) of the OSH Act. This information is used by OSHA to evaluate the alleged hazards and to schedule an inspection. The form is available in English and Spanish. OSHA-7 Form has been translated into nine Asian American Pacific Islander languages.

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Authorizing Statute(s): US Code: 29 USC 651 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:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	82 FR 18932	04/24/2017
30-day Notice:	Federal Register Citation:	Citation Date:
	82 FR 41659	09/01/2017
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
Notice of Alleged Safety or Health Hazards (OSHA-7 Form)	OSHA-7 Online, OSHA-7 (Spanish), OSHA-7 Online (Spanish), OSHA-7, OSHA-7, OSHA-7, OSHA-7, OSHA-7, OSHA-7, OSHA-7, OSHA-7, OSHA-7, OSHA-7	OSHA Form 7 Chinese ,   OSHA Form 7 Eastern Punjabi ,   OSHA Form 7 Korean ,   OSHA Form 7 Nepali ,   OSHA Form Tagalog ,   OSHA Form 7 Traditional Chinese ,   OSHA Form 7 Urdu ,   OSHA Form 7 Vietnamese ,   OSHA Form 7 Western Punjami ,   OSHA Online Complaint Form- Notice of Alleged Safety or Health Hazard ,   OSHA Online Complaint Form- Notice of Alleged Safety or Health Hazard (Spanish) ,   Notice of Alleged Safety and Health Hazards (paper form) ,   Notificación de una Queja en Seguridad y Salud

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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	70,976	50,641	0	0	20,335	0
Annual Time Burden (Hours)	19,258	13,659	0	0	5,599	0
Annual Cost Burden (Dollars)	701	13,659	0	0	-12,958	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: The Agency is requesting an adjustment increase of 5,599 burden hours (from 13,659 to 19,258). The difference is the result of an overall increase in complaints received annually from 50,641 complaints estimated in the previous ICR to 70,976 complaints. Proportionally, the distribution of complaints between electronic, written, and oral are believed to be within the same range as the previous ICR. Due to a data-entry problem in ROCIS for the previous ICR, the operation and maintenance costs reported in ROCIS decreased from 13,659 to 701. However, actual costs increased from $532 to $701. The increase occurred due to an increase in the estimated number of written OSHA-7 forms being received from 1,208 to 1,430 forms.

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Annual Cost to Federal Government: $278,014

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     Yes

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     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: 08/31/2017

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