Information Collection

Notice of Alleged Safety or Health Hazards (OSHA-7 Form)

IC 13971 under ICR 201707-1218-003 · OMB 1218-0064.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1218-0064 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form OSHA-7 Notice of Alleged Safety or Health Hazards (OSHA-7 Form)	Form
OSHA-7 OSHA Form 7 Chinese OSHA Form 7 Chinese.docx	Form
OSHA-7 OSHA Form 7 Eastern Punjabi OSHA Form 7 Eastern Punjabi.docx	Form
OSHA-7 OSHA Form 7 Korean OSHA Form 7 Korean.docx	Form
OSHA-7 OSHA Form 7 Nepali OSHA Form 7 Nepali.doc	Form
OSHA-7 OSHA Form Tagalog OSHA Form 7 Tagalog.docx	Form
OSHA-7 OSHA Form 7 Traditional Chinese OSHA Form 7 Traditional Chinese.docx	Form
OSHA-7 OSHA Form 7 Urdu OSHA Form 7 Urdu.docx	Form
OSHA-7 OSHA Form 7 Vietnamese OSHA Form 7 Vietnamese.docx	Form
OSHA-7 OSHA Form 7 Western Punjami OSHA Form 7 Western Punjabi.docx	Form
OSHA-7 Online OSHA Online Complaint Form- Notice of Alleged Safety or Notice of Alleged Safety or Health Hazards _ Occupational Safety and Health Administration (downloaded 07.06.17).pdf www.osha.gov/pls/osha7/eComplaintForm.html	Form and Instruction
OSHA-7 Online (Spa OSHA Online Complaint Form- Notice of Alleged Safety or Aviso de seguridad alegado o Peligros para la salud _ Administración de Segu.pdf www.osha.gov/pls/osha7/ecomplaintform_sp.html	Form and Instruction
OSHA-7 Notice of Alleged Safety and Health Hazards (paper form) Notice of Alleged Safety or Health Hazards (paper form) (downloaded 07.06.17).pdf www.osha.gov/oshforms/osha7.pdf	Form
OSHA-7 (Spanish) Notificación de una Queja en Seguridad y Salud Notice of Alleged Safety or Health Hazards (paper form, Spanish) (downloaded 07.06.17).pdf www.osha.gov/oshforms/OSHA7_SPANISH.pdf	Form
OSHA Worker Rights and Protections - How to File a Safety and Health Complaint _ Occupational Safety and Health Administration (downloaded 07.06.17).pdf How to File a Safety and Health Complaint with OSHA	IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

Notice of Alleged Safety or Health Hazards (OSHA-7 Form)

Agency IC Tracking Number:

1218-0064(2017)

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation: 29 CFR 1903.11

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
Form	OSHA-7	OSHA Form 7 Chinese	OSHA Form 7 Chinese.docx		Yes	Yes	Fillable Fileable
Form	OSHA-7	OSHA Form 7 Eastern Punjabi	OSHA Form 7 Eastern Punjabi.docx		Yes	Yes	Fillable Fileable
Form	OSHA-7	OSHA Form 7 Korean	OSHA Form 7 Korean.docx		Yes	Yes	Fillable Fileable
Form	OSHA-7	OSHA Form 7 Nepali	OSHA Form 7 Nepali.doc		Yes	Yes	Fillable Fileable
Form	OSHA-7	OSHA Form Tagalog	OSHA Form 7 Tagalog.docx		Yes	Yes	Fillable Fileable
Form	OSHA-7	OSHA Form 7 Traditional Chinese	OSHA Form 7 Traditional Chinese.docx		Yes	Yes	Fillable Fileable
Form	OSHA-7	OSHA Form 7 Urdu	OSHA Form 7 Urdu.docx		Yes	Yes	Fillable Fileable
Form	OSHA-7	OSHA Form 7 Vietnamese	OSHA Form 7 Vietnamese.docx		Yes	Yes	Fillable Fileable
Form	OSHA-7	OSHA Form 7 Western Punjami	OSHA Form 7 Western Punjabi.docx		Yes	Yes	Fillable Fileable
Form and Instruction	OSHA-7 Online	OSHA Online Complaint Form- Notice of Alleged Safety or Health Hazard	Notice of Alleged Safety or Health Hazards _ Occupational Safety and Health Administration (downloaded 07.06.17).pdf	https://www.osha.gov/pls/osha7/eComplaintForm.html	Yes	Yes	Fillable Fileable
Form and Instruction	OSHA-7 Online (Spanish)	OSHA Online Complaint Form- Notice of Alleged Safety or Health Hazard (Spanish)	Aviso de seguridad alegado o Peligros para la salud _ AdministraciÃ³n de Segu.pdf	https://www.osha.gov/pls/osha7/ecomplaintform_sp.html	Yes	Yes	Fillable Fileable
Form	OSHA-7	Notice of Alleged Safety and Health Hazards (paper form)	Notice of Alleged Safety or Health Hazards (paper form) (downloaded 07.06.17).pdf	https://www.osha.gov/oshforms/osha7.pdf	Yes	Yes	Fillable Fileable Signable
Form	OSHA-7 (Spanish)	NotificaciÃ³n de una Queja en Seguridad y Salud	Notice of Alleged Safety or Health Hazards (paper form, Spanish) (downloaded 07.06.17).pdf	https://www.osha.gov/oshforms/OSHA7_SPANISH.pdf	Yes	Yes	Fillable Fileable Signable

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: 70,976

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 52 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	70,976	20,335	50,641
Annual IC Time Burden (Hours)	19,258	5,599	13,659
Annual IC Cost Burden (Dollars)	701	-12,958	13,659

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
How to File a Safety and Health Complaint with OSHA	OSHA Worker Rights and Protections - How to File a Safety and Health Complaint _ Occupational Safety and Health Administration (downloaded 07.06.17).pdf	07/06/2017

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