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

Survey of Occupational Injuries and Illnesses

OMB: 1220-0045

IC ID: 179004

Documents and Forms
Document Name
Document Type
Form and Instruction
Instruction
Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
IC Document
IC Document
IC Document
IC Document
IC Document
IC Document
IC Document
IC Document
IC Document
IC Document
Information Collection (IC) Details

View Information Collection (IC)

Survey of Occupational Injuries and Ilnesses - State and Local - Mandatory
 
No Modified
 
Mandatory
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
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
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 Fax form Spanish Fax form.pdf Yes Yes Fillable Fileable

General Government Central Records & Statistical Mgt

 

14,400 0
   
State, Local, and Tribal Governments
 
   75 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 14,400 0 0 0 0 14,400
Annual IC Time Burden (Hours) 9,084 0 0 0 0 9,084
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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.pdf 04/17/2020
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.

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