Challenge Administrator

OSHA Challenge
Administrator Annual Report
Included in this spreadsheet are:
T ab 1. A dm inistrator A nnual R eport
T ab 2. S um m ary of P articipant Injury and Illness R ates - A utofills
T abs 3 - 12. Individual P articipant Inform ation
1.) S om e fields in this spreadsheet are program m ed to fill these form s autom atically.
D o not m anually enter data into these fields. A ll of T ab 2 autofills.
2.) T he year has been entered in all applicable boxes.
3.) E ach participant is to have their ow n tab. If you have m ore than 10 participants, copy the
of blank annual reports before entering inform ation first. E nsure that you have enough annu
report files for the total num ber of your participants.
4.) E nsure that all fields are filled in correctly.
5.) R em em ber to subm it an updated O C T P S for each participant along w ith this sum m ary.
6.) E nsure that the data inputted are consistent and accurate.
To access these documents, please click on the tabs at the bottom of this form.
T he O S H A C hallenge A dm inistrator m ust prepare the A dm inistrator A nnual R eport each
year along w ith an O S H A C hallenge T racking P articipant S tatus (O C T P S ) form for each
participant. B oth the annual report and all O C T P S form s m ust be subm itted electronically
to your O S H A C hallenge Liaison no later than February 15 each year.
OMB Control Number: 1218-0239 Expires 01-31-2018
P ublic reporting burden for this collection of inform ation is estim ated to average
20 hours per response, including tim e for review ing instructions, searching
existing data sources, gathering and m aintaining the data needed, and
com pleting and review ing the collection of inform ation. S end com m ents regarding

C h a lle n g e P ilo t
A d m in istra to r's A n n u a l R e p o rt - O ve rvie w