Form OSHA 6-40.1 OSHA 6-40.1 Serious Event Reporting Online Form

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

Serious Event Reporting Online Form _ Occupational Safety and Health Administration (downloaded 01.18.19)

Reporting Occupational Injuries and Illnesses

OMB: 1218-0176

Document [pdf]
Download: pdf | pdf
1/18/2019

Serious Event Reporting Online Form | Occupational Safety and Health Administration
UNITED STATES
DEPARTMENT OF LABOR

OSHA

English | Spanish

Find it in OSHA



A TO Z INDEX
ABOUT OSHA

WORKERS

EMPLOYERS

REGULATIONS

ENFORCEMENT

TOPICS

NEWS & PUBLICATIONS

DATA

TRAINING

Form No. OSHA 6-40.1.

Serious Event Reporting Online Form
Validation Check - Enter State of Event to determine reporting requirements.
*State

Select A State

Validation Check

Clear Form

NOTE: For employers covered by Federal OSHA that are located in State Plan States, to make a report
Call the nearest OSHA office.
Call the OSHA 24-hour hotline at 1-800-321-6742 (OSHA).

OMB Control Number: 1218-0176

Expiration Date: June 30, 2021

Public reporting for this collection of information is estimated to average 30 minutes per response, including the time for reviewing instructions, searching
existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Persons are not required to
respond to the collection of information unless it displays a currently valid Office of Management and Budget Control Number. If you have any comments
regarding this estimate or any other aspect of this information collection, including suggestions for reducing this burden, please send them to
[email protected] or to OSHA's Office of Statistical Analysis, Room N-3644, 200 Constitution Avenue, NW, Washington, DC 20210.

UNITED STATES
DEPARTMENT OF LABOR

Occupational Safety and Health Administration
200 Constitution Ave NW
Washington, DC 20210
 800-321-6742 (OSHA)
TTY
www.OSHA.gov
FEDERAL GOVERNMENT

OCCUPATIONAL SAFETY AND HEALTH

ABOUT THE SITE

White House

Frequently Asked Questions

Freedom of Information Act

Disaster Recovery Assistance

A - Z Index

Privacy & Security Statement

USA.gov

Freedom of Information Act

Disclaimers

No Fear Act Data

Read the OSHA Newsletter

Important Website Notices

U.S. Office of Special Counsel
https://www.osha.gov/pls/ser/serform.html

Subscribe to the OSHA Newsletter

Plug-Ins Used by DOL

1/2

1/18/2019

Serious OSHA
Event Publications
Reporting Online Form | Occupational Safety andAccessibility
Health Administration
Statement
Office of Inspector General

https://www.osha.gov/pls/ser/serform.html

2/2


File Typeapplication/pdf
File Modified0000-00-00
File Created0000-00-00

© 2024 OMB.report | Privacy Policy