Information Collection

Challenge Participant

IC 213271 under ICR 202101-1218-006 · OMB 1218-0239.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1218-0239 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Challenge Participant Application.docx www.osha.gov/dcsp/vpp/challenge/appandinstruct.html#!pa	Instruction
Challenge Participant Application.docx www.osha.gov/dcsp/vpp/challenge/appandinstruct.html#!pa	Instruction

IC Title:

Challenge Participant

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

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
Instruction			Challenge Participant Application.docx	https://www.osha.gov/dcsp/vpp/challenge/appandinstruct.html#!pa	Yes	Yes	Fillable Fileable

Line of Business: Workforce Management

Subfunction: Worker Safety

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 29

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	47	-96	143
Annual IC Time Burden (Hours)	730	-2,130	2,860
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

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