Survey of Occupational Injuries and Ilnesses - State and Local - Mandatory

Survey of Occupational Injuries and Illnesses

⚠️ Notice: This information collection may be referencing outdated material.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

Documents and Forms

Document Name Document Type
9300 IDCF - 2019 .docx Instruction
Item 15 - 2019 SOII instructions sheet - nonDJTR OMB revision with OSHA ITA_20190923.docx Instruction
BLS 9300 Survey of Occupational Injuries and Illnesses 9300_SOII_SY2019_Long_Form OMB.doc Form and Instruction
BLS 9300 FAX SOII FAX form 01_Alabama_2019.docx Form and Instruction
BLS 9300 N06 SOII Spanish Data Collection Booklet Item 1 - 2019 SOII Spanish Data Collection Book OMB revision.docx Form and Instruction
IDCF Screenshots SOII IDCF screenshots 2019 (002).docx Form and Instruction
Item 5 - 2020 SOII instructions sheet - Mand_prenote.docx 2020 Instruction sheet - manadatory prenote IC Document
Item 17 - Non-Response letter 1_2019.docx Non-response Letter 1 IC Document
Item 18 - Non-Response letter 2_2019.docx Non-response letter 2 IC Document
SOII Informed Consent Letter.pdf SOII Informed consent letter IC Document
Item 23 - Mandatory Pre-Notification_2020.docx Mandatory Prenote 2020 IC Document
Item 16 - 2019 Internet pamphlet.docx Internet Pamphlet IC Document
Item 5 - 2020 Prenote Leaflet.docx Prenote Leaflet IC Document
Data_Collection_email_message.docx Data Collection password email IC Document
Mandatory_Prenote_email_message.docx Mandatory prenote email message IC Document
Data_Collection_email_message.docx Data Collection email message IC Document

Information Collection (IC) Details

IC Title:	Survey of Occupational Injuries and Ilnesses - State and Local - Mandatory	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Instruction			Item 15 - 2019 SOII instructions sheet - nonDJTR OMB revision with OSHA ITA_20190923.docx	Yes	Yes	Fillable Fileable
Form and Instruction	BLS 9300	Survey of Occupational Injuries and Illnesses	9300_SOII_SY2019_Long_Form OMB.doc	Yes	Yes	Fillable Printable
Instruction			9300 IDCF - 2019 .docx	Yes	Yes	Fillable Fileable
Form and Instruction	BLS 9300 FAX	SOII FAX form	01_Alabama_2019.docx	Yes	Yes	Fillable Fileable
Form and Instruction	BLS 9300 N06	SOII Spanish Data Collection Booklet	Item 1 - 2019 SOII Spanish Data Collection Book OMB revision.docx	Yes	No	Fillable Printable
Form and Instruction	IDCF	Screenshots	SOII IDCF screenshots 2019 (002).docx	Yes	Yes	Fillable Fileable

Line of Business: General Government

Subfunction: Central Records & Statistical Mgt

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 14,400	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 75 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	14,400	1,400	13,000
Annual IC Time Burden (Hours)	9,084	-392	9,476
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded
2020 Instruction sheet - manadatory prenote	Item 5 - 2020 SOII instructions sheet - Mand_prenote.docx	08/21/2019
Non-response Letter 1	Item 17 - Non-Response letter 1_2019.docx	08/21/2019
Non-response letter 2	Item 18 - Non-Response letter 2_2019.docx	08/21/2019
SOII Informed consent letter	SOII Informed Consent Letter.pdf	08/21/2019
Mandatory Prenote 2020	Item 23 - Mandatory Pre-Notification_2020.docx	08/21/2019
Internet Pamphlet	Item 16 - 2019 Internet pamphlet.docx	08/21/2019
Prenote Leaflet	Item 5 - 2020 Prenote Leaflet.docx	08/21/2019
Data Collection password email	Data_Collection_email_message.docx	08/21/2019
Mandatory prenote email message	Mandatory_Prenote_email_message.docx	08/21/2019
Data Collection email message	Data_Collection_email_message.docx	08/21/2019

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