Information Collection

Survey of Occupational Injuries and Illnesses - Private Sector

IC 38596 under ICR 201709-1220-002 · OMB 1220-0045.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1220-0045 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form BLS 9300 Survey of Occupational Injuries and Illnesses - Private Sector	Form and Instruction
IDCF - 2016_revised.pdf	Instruction
2016 SOII instructions sheet - DJTR_revised.pdf	Instruction
2016 SOII instructions sheet - nonDJTR_revised.pdf	Instruction
BLS 9300 Survey of Occupational Injuries and Illnesses SOII_SY2016_Long_Form.pdf	Form and Instruction
IDCF IDCF Screen Shots SOII IDCF ADOBE Screenshots.docx	Form and Instruction
BLS 9300 N06 SoII Data Collection Booklet - Spanish Version Item 1 - 2016 SOII Spanish Data Collection Book.pdf	Form and Instruction
BLS9300 FAX SOII 2016 01_Alabama_2016.pdf	Form and Instruction
2017 SOII instructions sheet - Mand_prenote_revised.pdf 2017 Prenote - Mandatory	IC Document
Non-Response letter 1_2016_revised.pdf Non-response Letter 1	IC Document
Non-Response letter 2_2016_revised.pdf Non-response letter 2	IC Document
Non-Response letter 1 DJTR_2016.pdf Non-response letter 1 DJTR	IC Document
Non-Response letter 2 DJTR_2016.pdf Non-response letter 2 - DJTR	IC Document
Data_collection_password_email.docx Data Collection password email	IC Document
Mandatory_Prenote_email_message.docx Mandatory Prenote email	IC Document
SOII Informed Consent Letter.pdf Informed Consent Letter	IC Document
Mandatory Pre-Notification-DJTR_2017.pdf Mandatory Prenote DJTR 2017	IC Document
Mandatory Pre-Notification_2017.pdf Mandatory Prenote 2017	IC Document
Mandatory DJTR letter data collection_2016.pdf Mandatory DJTR letter 2016	IC Document
2016 Internet pamphlet_revised.pdf 2016 Internet Pamphlet	IC Document
2018 Prenote Leaflet.docx 2018 Prenote Leaflet	IC Document
Data_Collection_email_message.docx Data Collection Email message	IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

Survey of Occupational Injuries and Illnesses - Private Sector

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	BLS 9300	Survey of Occupational Injuries and Illnesses	SOII_SY2016_Long_Form.pdf	Yes	Yes	Fillable Printable
Form and Instruction	IDCF	IDCF Screen Shots	SOII IDCF ADOBE Screenshots.docx	Yes	Yes	Fillable Fileable
Form and Instruction	BLS 9300 N06	SoII Data Collection Booklet - Spanish Version	Item 1 - 2016 SOII Spanish Data Collection Book.pdf	Yes	Yes	Fillable Printable
Instruction			IDCF - 2016_revised.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	BLS9300 FAX	SOII 2016	01_Alabama_2016.pdf	Yes	Yes	Fillable Fileable
Instruction			2016 SOII instructions sheet - DJTR_revised.pdf	Yes	Yes	Fillable Fileable
Instruction			2016 SOII instructions sheet - nonDJTR_revised.pdf	Yes	Yes	Fillable Fileable

Federal Enterprise Architecture Business Reference Module

Line of Business: General Government

Subfunction: Central Records & Statistical Mgt

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 220,000

Number of Respondents for Small Entity: 104,849

Affected Public: Private Sector

Private Sector: Businesses or other for-profits, Farms, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 75 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	220,000	220,000
Annual IC Time Burden (Hours)	289,334	289,334
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
2017 Prenote - Mandatory	2017 SOII instructions sheet - Mand_prenote_revised.pdf	09/19/2016
Non-response Letter 1	Non-Response letter 1_2016_revised.pdf	09/19/2016
Non-response letter 2	Non-Response letter 2_2016_revised.pdf	09/19/2016
Non-response letter 1 DJTR	Non-Response letter 1 DJTR_2016.pdf	06/29/2016
Non-response letter 2 - DJTR	Non-Response letter 2 DJTR_2016.pdf	06/29/2016
Data Collection password email	Data_collection_password_email.docx	06/29/2016
Mandatory Prenote email	Mandatory_Prenote_email_message.docx	06/29/2016
Informed Consent Letter	SOII Informed Consent Letter.pdf	06/29/2016
Mandatory Prenote DJTR 2017	Mandatory Pre-Notification-DJTR_2017.pdf	06/29/2016
Mandatory Prenote 2017	Mandatory Pre-Notification_2017.pdf	06/29/2016
Mandatory DJTR letter 2016	Mandatory DJTR letter data collection_2016.pdf	06/29/2016
2016 Internet Pamphlet	2016 Internet pamphlet_revised.pdf	09/19/2016
2018 Prenote Leaflet	2018 Prenote Leaflet.docx	09/12/2017
Data Collection Email message	Data_Collection_email_message.docx	06/30/2016

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