Notice of Alleged Safety or Health Hazards (OSHA-7 Form)

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form OSHA-7 (Spanish, o Notificacion de Alegacion de Riesgos a la Seguridad o Salud	Form and Instruction	Modified	Repair queued
Form OSHA-7 (English, o OSHA Online Complaint Form - Notice of Alleged Safety and Health Hazard	Form and Instruction	Modified	Repair queued
Form OSHA-7 (English, o Notice of Alleged Safety or Health Hazards (OSHA-7 Form)	Form and Instruction	Modified	Repair queued
Form OSHA-7 (Spanish, d Notificación de una Queja en Seguridad y Salud	Form and Instruction	Modified	Repair queued
Form OSHA-7 (Enlish, do Notice of Alleged Safety and Health Hazards (downloadable)	Form and Instruction	Modified	Repair queued
OSHA 7 Complaint Form (1218-0064 Supporting Statement)11.11.2020 FINAL.docx	Supporting Statement A	Uploaded 2020-11-19	Repair queued
30-day FRN (1218-0064) published.pdf	Supplementary Document	Uploaded 2020-11-19	Repair queued
60-day FRN (1218-0064) published.pdf	Supplementary Document	Uploaded 2020-11-19	Repair queued
eCFR 1903.11.docx	Supplementary Document	Uploaded 2014-05-30	Repair queued
29 USC 657.docx	Supplementary Document	Uploaded 2014-05-30	Repair queued
29 USC 651.docx	Supplementary Document	Uploaded 2014-05-30	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
13971	Notice of Alleged Safety or Health Hazards (OSHA-7 Form)	Form and Instruction	Modified	Notificacion de Alegacion de Riesgos a la Seguridad o Salud
13971	Notice of Alleged Safety or Health Hazards (OSHA-7 Form)	Form and Instruction	Modified	OSHA Online Complaint Form - Notice of Alleged Safety and Health Hazard
13971	Notice of Alleged Safety or Health Hazards (OSHA-7 Form)	Form and Instruction	Modified
13971	Notice of Alleged Safety or Health Hazards (OSHA-7 Form)	Form and Instruction	Modified	Notificación de una Queja en Seguridad y Salud
13971	Notice of Alleged Safety or Health Hazards (OSHA-7 Form)	Form and Instruction	Modified	Notice of Alleged Safety and Health Hazards (downloadable)

ICR Details

OMB Control No: 1218-0064	ICR Reference No: 202008-1218-004
Status: Historical Active	Previous ICR Reference No: 201707-1218-003
Agency/Subagency: DOL/OSHA	Agency Tracking No: 1218-0064(2020)
Title: Notice of Alleged Safety or Health Hazards (OSHA-7 Form)
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 07/20/2021
Retrieve Notice of Action (NOA)	Date Received in OIRA: 11/19/2020
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	07/31/2024	36 Months From Approved	07/31/2021
Responses	76,036	0	70,976
Time Burden (Hours)	21,171	0	19,258
Cost Burden (Dollars)	336	0	701

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Abstract: The OSHA-7 Form is used by OSHA personnel to report unhealthful and/or unsafe conditions in the workplace. The information is given to OSHA by employees who wish to report unhealthful and/or unsafe conditions at their place of employment. Employee reports are authorized by Section 8(f)(1) of the OSH Act. This information is used by OSHA to evaluate the alleged hazards and to schedule an inspection. The form is available in English and Spanish. OSHA-7 Form has been translated into nine Asian American Pacific Islander languages.

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Authorizing Statute(s): US Code: 29 USC 651 Name of Law: Occupational Safety and Health Act
   US Code: 29 USC 657 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:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	85 FR 27765	05/11/2020
30-day Notice:	Federal Register Citation:	Citation Date:
	85 FR 73809	11/19/2020
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

table that charts list of burden

IC Title	Form No.	Form Name
Notice of Alleged Safety or Health Hazards (OSHA-7 Form)	OSHA-7 (English, online), OSHA-7 (Spanish, online), OSHA-7 (Enlish, downloadable), OSHA-7 (Spanish, downloadable)	Notice of Alleged Safety and Health Hazards (downloadable) ,   Notificación de una Queja en Seguridad y Salud ,   OSHA Online Complaint Form - Notice of Alleged Safety and Health Hazard ,   Notificacion de Alegacion de Riesgos a la Seguridad o Salud

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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	76,036	70,976	0	0	5,060	0
Annual Time Burden (Hours)	21,171	19,258	0	0	1,913	0
Annual Cost Burden (Dollars)	336	701	0	0	-365	0

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

Burden Increase Due to:

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

Burden Reduction Due to:

Short Statement: The agency is requesting an adjustment increase of 1,912.90 burden hours (from 19,258 to 21,170.90). The increase is a result of an estimated increase of 5,060 complaints received annually from 70,976 in the previous ICR to 76,036. Additionally, in the period since the last approval, the agency has experienced a shift away from complaints received in writing to those received electronically. The burden hour increase is off-set by a decrease in burden hours related to this shift. The agency also requests an adjustment decrease in operation and maintenance costs of $365.50 (from $701 to $335.50). The decrease occurred due to a decrease in the estimated number of written OSHA-7 forms being mailed from 1,430 to 610 forms. In addition, OSHA proposes several minor editorial and non-substantive revisions to the OSHA-7 Form to clarify instructions and modernize information sharing. The minor edits are also requested in response to feedback from field management, as well as to ensure consistency with current agency policies and procedures. The agency does not believe that the proposed revisions to the complaint form will further impact the adjusted burden hours.

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Annual Cost to Federal Government: $379,870

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? No

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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: 11/19/2020

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