U.S.
Department of Labor Bureau
of Labor Statistics
MANDATORY
REPORT – DATED MATERIAL U.S.
GOVERNMENT DOCUMENTS ENCLOSED
DISTRICT
OF COLUMBIA DEPARTMENT OF LABOR STATE
SECONDARY NAME STREET
ADDRESS MONTGOMERY,
AL 36130-3500
For Help
Call: 334-242-3462 ext. 9999
334-242-3463 ext. 9999
334-242-3463 ext. 9999
334-242-3463 ext. 9999
Fax: 334-242-3333
NAICS: 512110 - Motion Picture and Video Production
12345 50
2020 Establishment ID: 01-203479880-2020
Report for:
The Unit Description goes here
PRIMARY COMPANY NAME
{SECONDARY COMPANY NAME}
ADDRESS LINE 1
ADDRESS LINE 2
CITY, STATE ZIP-PLUS+4
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Notice of Recordkeeping Requirements for the
2020 Survey of Occupational Injuries and Illnesses
YOUR PARTICIPATION IS REQUIRED BY LAW
What
must you do now?
Keep
a record of all recordable work-related injuries and illnesses
that occur between January 1 and December 31, 2020, for the
establishment(s) identified above.
When
will you receive the Survey? In
January 2021, you
will receive the Survey of Occupational Injuries and Illnesses
(SOII). Use the records you have kept throughout the year to
complete the Survey.
What
if you have questions? Visit
our respondents’ page at www.bls.gov/respondents/iif
for more information about the Survey of Occupational Injuries and
Illnesses and your recordkeeping requirements. Contact
us at the phone number(s) listed above for help clarifying the
establishment(s) for which you should keep records.
Overview of Your Recordkeeping Requirements
You must maintain the information required for all recordable work-related injuries and illnesses that occur during calendar year 2020 for the establishment(s) identified on the front.
The enclosed OSHA Forms for Recording Work-Related Injuries and Illnesses provide instructions for filling out the Log of Work-Related Injuries and Illnesses (OSHA Form 300) and the Injury and Illness Incident Report (OSHA Form 301). In addition, this survey will ask for optional race and/or ethnicity information that is not included on the OSHA forms.
At the end of 2019, complete the enclosed Summary of Work-Related Injuries and Illnesses (OSHA Form 300A) even if you had NO work-related injuries or illnesses.
In January 2021, you will be sent instructions for completing the Survey of Occupational Injuries and Illnesses.
If you have any questions about your record-keeping requirements for this survey, or if you need help, call the phone number(s) on the front of this form.
How Your Injury and Illness Data Are Used
Your data are important for making American workplaces safer. Data you report are aggregated with data from other establishments and used to identify injury and illness patterns among industries and occupations. For more information about injury and illness statistics, please visit our website at www.bls.gov/iif.
File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
File Title | Survey of Occupational Injuries |
Author | kurlick_g |
File Modified | 0000-00-00 |
File Created | 2021-01-13 |