Information Collection

Survey of Occupational Injuries and Illnesses - Private Sector

IC 38596 under ICR 202010-1220-002 · OMB 1220-0045.

Documents and Forms

Documents and forms in this information collection
Document NameDocument Type
Form IDCF
Survey of Occupational Injuries and Illnesses - Private Sector
Form and Instruction
9300 IDCF - 2019 .docx Instruction
Item 000 - 2020 SOII instructions sheet - nonDJTRITA.docx Instruction
BLS 9300 Survey Of Occupational Injuries and Illnesses
SOII_SY2020_Long_Form OMB.docx
Form and Instruction
BLS 9300 FAX Fax Form 2020 Example
AK_2020.docx
Form and Instruction
BLS 9300 N06 SOII Data Collection Booklet - Spanish Version
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
BLS 9300 FAX SOII FAX form
Fax_form_English_2020 generic.docx
Form and Instruction
BLS 9300 FAX SOII FAX form
Spanish Fax form.pdf
Form and Instruction
IDCF IDCF UPdates for OSHA ITA
SOII IDCF Screenshots Update.pdf
Form and Instruction
Item 17 - Non-Response letter 1_2019.docx
Non-response Letter 1
IC Document
Item 18 - Non-Response letter 2_2020.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 Pre-Note 2020
IC Document
Item 16 - 2019 Internet pamphlet.docx
2019 Internet Pamphlet
IC Document
Item 5 - 2020 Prenote Leaflet.docx
2020 Pre-Note Leaflet
IC Document
Item 5 - 2020 SOII instructions sheet - Mand_prenote.docx
2020 SOII Instruction sheet - mandatory prenote
IC Document
Data_collection_password_email.docx
Data collection password email
IC Document
Mandatory_Prenote_email_message.docx
Mandatory Prenote email
IC Document
Data_Collection_email_message.docx
Data Collection email
IC Document
Georgia Sample Reduction Letter 2020.docx
GA opt out letter
IC Document

Information Collection (IC) Details

View Information Collection (IC)

layout table

Information Collection Instruments:
table that charts list of instruments
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 SOII_SY2020_Long_Form OMB.docx Yes Yes Fillable Printable
Instruction 9300 IDCF - 2019 .docx Yes Yes Fillable Fileable
Form and Instruction BLS 9300 FAX Fax Form 2020 Example AK_2020.docx Yes Yes Fillable Fileable
Form and Instruction BLS 9300 N06 SOII Data Collection Booklet - Spanish Version Item 1 - 2019 SOII Spanish Data Collection Book OMB revision.docx Yes Yes Fillable Printable
Instruction Item 000 - 2020 SOII instructions sheet - nonDJTRITA.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 Fax_form_English_2020 generic.docx Yes Yes Fillable Fileable
Form and Instruction BLS 9300 FAX SOII FAX form Spanish Fax form.pdf Yes Yes Fillable Fileable
Form and Instruction IDCF IDCF UPdates for OSHA ITA SOII IDCF Screenshots Update.pdf Yes Yes Fillable Fileable

Federal Enterprise Architecture Business Reference Module


table that charts list of burden
  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 207,696 0 -4,104 0 0 211,800
Annual IC Time Burden (Hours) 170,303 0 -2,897 0 0 173,200
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Documents for IC
table that charts IC Documents
Title Document Date Uploaded
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_2020.docx 08/06/2020
SOII Informed Consent Letter SOII Informed Consent Letter.pdf 08/21/2019
Mandatory Pre-Note 2020 Item 23 - Mandatory Pre-Notification_2020.docx 08/21/2019
2019 Internet Pamphlet Item 16 - 2019 Internet pamphlet.docx 08/21/2019
2020 Pre-Note Leaflet Item 5 - 2020 Prenote Leaflet.docx 08/21/2019
2020 SOII Instruction sheet - mandatory prenote Item 5 - 2020 SOII instructions sheet - Mand_prenote.docx 08/21/2019
Data collection password email Data_collection_password_email.docx 08/21/2019
Mandatory Prenote email Mandatory_Prenote_email_message.docx 08/21/2019
Data Collection email Data_Collection_email_message.docx 08/21/2019
GA opt out letter Georgia Sample Reduction Letter 2020.docx 10/28/2020
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.