Information Collection

Survey of Occupational Injuries and Illnesses - Private Sector

IC 38596 under ICR 201809-1220-003 · 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⚠️ Notice: This information collection may be referencing outdated material.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
Item 15 -- IDCF - 2018.pdf	Instruction
Item 000 - 2018 SOII instructions sheet - DJTR.pdf	Instruction
Item 000 - 2018 SOII instructions sheet - nonDJTR.pdf	Instruction
BLS 9300 Survey of Occupational Injuries and Illnesses SOII_SY2018_Long_Form.pdf	Form and Instruction
IDCF IDCF Screen Shots SOII IDCF_20181004.docx	Form and Instruction
BLS 9300 N06 SoII Data Collection Booklet - Spanish Version Item 1 - 2018 SOII Spanish Data Collection Book.pdf	Form and Instruction
BLS9300 FAX SOII 2016 Fax form 2018 Example.pdf	Form and Instruction
Item 000 - 2019 SOII instructions sheet - Mand_prenote.pdf 2017 Prenote - Mandatory	IC Document
Item 17 - Non-Response letter 1_2018.pdf Non-response Letter 1	IC Document
Item 18 - Non-Response letter 2_2018.pdf Non-response letter 2	IC Document
Item 26 - Non-Response letter 1 DJTR_2018.pdf Non-response letter 1 DJTR	IC Document
Item 27 - Non-Response letter 2 DJTR_2018.pdf Non-response letter 2 - DJTR	IC Document
Data_collection_password RY2018.docx Data Collection password email	IC Document
Mandatory_Prenote 2019.docx Mandatory Prenote email	IC Document
SOII Informed Consent Letter.pdf Informed Consent Letter	IC Document
Item 24 - Mandatory Pre-Notification-DJTR_2019.pdf Mandatory Prenote DJTR 2019	IC Document
Item 23 - Mandatory Pre-Notification_2019.pdf Mandatory Prenote 2019	IC Document
Item 25 - Mandatory DJTR letter data collection_2018.pdf Mandatory DJTR letter 2016	IC Document
Item 16 -- 2018 Internet pamphlet.pdf 2016 Internet Pamphlet	IC Document
Item 5 -- 2019 Prenote Leaflet.pdf 2018 Prenote Leaflet	IC Document
Data_Collection RY2018.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
Instruction			Item 000 - 2018 SOII instructions sheet - DJTR.pdf	Yes	Yes	Fillable Fileable
Instruction			Item 000 - 2018 SOII instructions sheet - nonDJTR.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	BLS 9300	Survey of Occupational Injuries and Illnesses	SOII_SY2018_Long_Form.pdf	Yes	Yes	Fillable Printable
Form and Instruction	IDCF	IDCF Screen Shots	SOII IDCF_20181004.docx	Yes	Yes	Fillable Fileable
Form and Instruction	BLS 9300 N06	SoII Data Collection Booklet - Spanish Version	Item 1 - 2018 SOII Spanish Data Collection Book.pdf	Yes	Yes	Fillable Printable
Instruction			Item 15 -- IDCF - 2018.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	BLS9300 FAX	SOII 2016	Fax form 2018 Example.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	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	220,000	0	220,000
Annual IC Time Burden (Hours)	296,651	3,067	293,584
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
2017 Prenote - Mandatory	Item 000 - 2019 SOII instructions sheet - Mand_prenote.pdf	10/10/2018
Non-response Letter 1	Item 17 - Non-Response letter 1_2018.pdf	10/10/2018
Non-response letter 2	Item 18 - Non-Response letter 2_2018.pdf	10/10/2018
Non-response letter 1 DJTR	Item 26 - Non-Response letter 1 DJTR_2018.pdf	10/10/2018
Non-response letter 2 - DJTR	Item 27 - Non-Response letter 2 DJTR_2018.pdf	10/10/2018
Data Collection password email	Data_collection_password RY2018.docx	10/10/2018
Mandatory Prenote email	Mandatory_Prenote 2019.docx	10/10/2018
Informed Consent Letter	SOII Informed Consent Letter.pdf	06/29/2016
Mandatory Prenote DJTR 2019	Item 24 - Mandatory Pre-Notification-DJTR_2019.pdf	10/10/2018
Mandatory Prenote 2019	Item 23 - Mandatory Pre-Notification_2019.pdf	10/10/2018
Mandatory DJTR letter 2016	Item 25 - Mandatory DJTR letter data collection_2018.pdf	10/10/2018
2016 Internet Pamphlet	Item 16 -- 2018 Internet pamphlet.pdf	10/10/2018
2018 Prenote Leaflet	Item 5 -- 2019 Prenote Leaflet.pdf	10/10/2018
Data Collection Email message	Data_Collection RY2018.docx	10/10/2018

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