Part B Clearance Signature Form

PRA Signature Form_OHSMS_(2021_0624).pdf

Employer Adoption of Voluntary Health and Safety Standards

Part B Clearance Signature Form

OMB: 1290-0036

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U.S. DEPARTMENT OF LABOR
Chief Evaluation Office Concurrence of Surveys Employing Statistical Methods
TO:

Carrie Snidar

DATE PREPARED: 06/24/2021

PHONE: 202-693-3881
FROM:

Scott Gibbons

PHONE: 202-693-5075
ACTION: Review the attached report proposal, indicate approval or disapproval, and return to the sponsoring agency
or program. Comments shall not be made on the proposed report but in the comments space below.

TITLE OF SURVEY OR EVALUATION:

Survey to Collect Data on Use and Effectiveness of Voluntary Consensus Standards for
Occupational Safety and Health Management
CLEARANCE:
__X__ Approved
_____ Disapproved (see below)
_____ Approved with comments (see below)
COMMENTS:
(Insert additional pages as needed)

Disclaimer: CEO is approving only the statistical methodology as presented in the written documentation and not
necessarily passing judgment on the questionnaire itself nor on the necessity of conducting the collection of
information.

SIGNATURE OF REVIEWER


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File Modified2021-06-24
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