Public Sector - Voluntary

Survey of Occupational Injuries and Illnesses

OMB: 1220-0045

IC ID: 192801

⚠️ Notice: This information collection may be referencing outdated material.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
Form BLS9300 FAX Public Sector - Voluntary Form and Instruction
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
BLS9300 FAX SOII Fax Form 01_Alabama_2019.docx Form and Instruction
IDCF Screenshots SOII IDCF screenshots 2019 (002).docx Form and Instruction
BLS 9300 FAX SOII FAX Form English Fax form.pdf Form and Instruction
BLS 9300 FAX SOII Spanish FAX form Spanish Fax form.pdf Form and Instruction
Data_collection_password_email.docx Data Collection password email IC Document
Data_Collection_email_message.docx Data Collection Email IC Document
Voluntary_Prenote_email_message.docx Voluntary Prenote email IC Document
Item 5 - 2020 SOII instructions sheet - Vol_prenote.docx Pre-note Voluntary IC Document
Item 19 - Voluntary Public Sector Letter for Pre-Notification_2020.docx Voluntary Public Sector for Pre-Notification IC Document
Item 20 - Voluntary Public Sector Letter for data collection_2019.docx Voluntary Public Sector letter for Data collection IC Document
SOII Informed Consent Letter.pdf Informed Consent Letter IC Document
Item 21 - Voluntary Public Sector Letter for NR1_2019.docx Nonresponse Letter 1 - Vol IC Document
Item 22 - Voluntary Public Sector Letter for NR2.docx Nonresponse Letter 2 - Vol IC Document
Item 16 - 2019 Internet pamphlet.docx Internet Pamphlet IC Document
Item 5 - 2020 Prenote Leaflet.docx Prenote Leaflet IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Public Sector - Voluntary	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	BLS9300 FAX	SOII Fax Form	01_Alabama_2019.docx	Yes	Yes	Fillable Fileable
Instruction			Item 15 - 2019 SOII instructions sheet - nonDJTR OMB revision with OSHA ITA_20190923.docx	Yes	Yes	Fillable Fileable
Form and Instruction	IDCF	Screenshots	SOII IDCF screenshots 2019 (002).docx	Yes	Yes	Fillable Fileable
Form and Instruction	BLS 9300 FAX	SOII FAX Form	English Fax form.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	BLS 9300 FAX	SOII Spanish FAX form	Spanish Fax form.pdf	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

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: 6,200	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 75 %

	Approved	Previously Approved
Annual Number of Responses for this IC	6,200	6,200
Annual IC Time Burden (Hours)	12,776	12,776
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Data Collection password email	Data_collection_password_email.docx	08/21/2019
Data Collection Email	Data_Collection_email_message.docx	08/21/2019
Voluntary Prenote email	Voluntary_Prenote_email_message.docx	08/21/2019
Pre-note Voluntary	Item 5 - 2020 SOII instructions sheet - Vol_prenote.docx	08/21/2019
Voluntary Public Sector for Pre-Notification	Item 19 - Voluntary Public Sector Letter for Pre-Notification_2020.docx	08/21/2019
Voluntary Public Sector letter for Data collection	Item 20 - Voluntary Public Sector Letter for data collection_2019.docx	08/21/2019
Informed Consent Letter	SOII Informed Consent Letter.pdf	08/21/2019
Nonresponse Letter 1 - Vol	Item 21 - Voluntary Public Sector Letter for NR1_2019.docx	08/21/2019
Nonresponse Letter 2 - Vol	Item 22 - Voluntary Public Sector Letter for NR2.docx	01/29/2020
Internet Pamphlet	Item 16 - 2019 Internet pamphlet.docx	08/21/2019
Prenote Leaflet	Item 5 - 2020 Prenote Leaflet.docx	08/21/2019

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