Recordkeeping and Reporting Occupational Injuries and Illnesses (29 CFR Part 1904)

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form 1 Professional Sports Team One-Tome Survey	Form and Instruction	New	Repair queued
Form OSHA 6-40.1 Serious Event Reporting Online Form	Form and Instruction	Unchanged	Repair queued
Form OSHA 6-40.2 OSHA Injury Tracking Application (mock-up of screen collecting EIN information)	Form	Unchanged	Available
Form OSHA 6-40.2 OSHA Injury Tracking Application Login screenshot	Form and Instruction	Unchanged	Available
Form OSHA Forms 300, 30 Log of Work Related Injuries and Illnesses, Summary of Work-Related Injuries and Illnesses, Injury and Illness Incident Report	Form and Instruction	Unchanged	Repair queued
Form OSHA Forms 300, 30 Log of Work Related Injuries and Illnesses, Summary of Work-Related Injuries and Illnesses, Injury and Illness Incident Reporting (Excel spreadsheets)	Form	Unchanged	Available
Professional Sports Team One-Time Survey Justification.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2019-05-24	Available
Appx A 1218-0176 tracking final rule 01.24.19.docx	Supplementary Document	Uploaded 2019-01-24	Available
ss 1218-0176 tracking final rule 01.24.19.docx	Supporting Statement A	Uploaded 2019-01-24	Available
29 CFR 1904 (CFR-2018-title29-vol5) downloaded 01.10.19.pdf	Supplementary Document	Uploaded 2019-01-10	Available
29 USC 673 Sec 24.pdf	Supplementary Document	Uploaded 2008-01-16	Available
29 USC 657 Sec 8.pdf	Supplementary Document	Uploaded 2008-01-15	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
236063	Professional Sports Team One-Time Survey	Form and Instruction	New	Professional Sports Team One-Tome Survey
212582	Reporting Occupational Injuries and Illnesses	Form and Instruction	Unchanged	Serious Event Reporting Online Form
14117	Recordkeeping Occupational Injuries and Illnesses (29 CFR Part 1904)	Form	Unchanged	OSHA Injury Tracking Application (mock-up of screen collecting EIN information)
14117	Recordkeeping Occupational Injuries and Illnesses (29 CFR Part 1904)	Form and Instruction	Unchanged	OSHA Injury Tracking Application Login screenshot
14117	Recordkeeping Occupational Injuries and Illnesses (29 CFR Part 1904)	Form and Instruction	Unchanged	Log of Work Related Injuries and Illnesses, Summary of Work-Related Injuries and Illnesses, Injury and Illness Incident Report
14117	Recordkeeping Occupational Injuries and Illnesses (29 CFR Part 1904)	Form	Unchanged	Log of Work Related Injuries and Illnesses, Summary of Work-Related Injuries and Illnesses, Injury and Illness Incident Reporting (Excel spreadsheets)
14117	Recordkeeping Occupational Injuries and Illnesses (29 CFR Part 1904)	Instruction	Unchanged

ICR Details

OMB Control No: 1218-0176	ICR Reference No: 201905-1218-002
Status: Historical Active	Previous ICR Reference No: 201901-1218-001
Agency/Subagency: DOL/OSHA	Agency Tracking No: 1218-0176(2019) Final Rule
Title: Recordkeeping and Reporting Occupational Injuries and Illnesses (29 CFR Part 1904)
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 06/20/2019
Retrieve Notice of Action (NOA)	Date Received in OIRA: 05/24/2019
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	03/31/2022	03/31/2022	03/31/2022
Responses	5,904,031	0	5,903,976
Time Burden (Hours)	2,140,861	0	2,140,856
Cost Burden (Dollars)	0	0	0

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Abstract: The OSH Act and 29 CFR Part 1904 prescribe that certain employers maintain records of job related injuries and illnesses. The data are needed by OSHA to carry out intervention and enforcement activities to guarantee workers safe and healthful workplaces. The data are also needed by BLS to produce national statistics on occupational injuries and illnesses.

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Authorizing Statute(s): US Code: 29 USC 657(c) Name of Law: Occupational Safety and Health Act
   US Code: 29 USC 673 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:
1218-AC49	Final or interim final rulemaking	84 FR 380	01/25/2019

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	83 FR 36494	07/30/2018
30-day Notice:	Federal Register Citation:	Citation Date:
	83 FR 36494	07/30/2018
Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 3

table that charts list of burden

IC Title	Form No.	Form Name
Professional Sports Team One-Time Survey	1	Professional Sports Team One-Tome Survey
Recordkeeping Occupational Injuries and Illnesses (29 CFR Part 1904)	OSHA Forms 300, 300A and 301, OSHA Forms 300, 300A and 301, OSHA 6-40.2, OSHA 6-40.2	Log of Work Related Injuries and Illnesses, Summary of Work-Related Injuries and Illnesses, Injury and Illness Incident Reporting (Excel spreadsheets) ,   Log of Work Related Injuries and Illnesses, Summary of Work-Related Injuries and Illnesses, Injury and Illness Incident Report ,   OSHA Injury Tracking Application Login screenshot ,   OSHA Injury Tracking Application (mock-up of screen collecting EIN information)
Reporting Occupational Injuries and Illnesses	OSHA 6-40.1	Serious Event Reporting Online Form

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ICR Summary of Burden

table that charts list 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	5,904,031	5,903,976	0	55	0	0
Annual Time Burden (Hours)	2,140,861	2,140,856	0	5	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: This is a non material change for a currently approved collection.

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Annual Cost to Federal Government: $779,600

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.     No

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: 05/24/2019

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