Challenge Participant

Voluntary Protection Program Information

⚠️ Notice: This information collection may be referencing outdated material.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

Documents and Forms

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

Information Collection (IC) Details

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:

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 %

	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

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.