Information Collection

Public Sector - Voluntary

IC 192801 under ICR 202111-1220-002 · OMB 1220-0045.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1220-0045 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form BLS 9300 Public Sector - Voluntary	Form and Instruction
Item 000 - 2021 SOII instructions sheet - Voluntary.docx	Instruction
Item 000 - 2021 SOII instructions sheet - Voluntary.docx	Instruction
BLS 9300 Survey of Occupational Injuries and Illnesses SOII_SY2021_Long_Form.docx	Form and Instruction
BLS 9300 Survey of Occupational Injuries and Illnesses SOII_SY2021_Long_Form.docx	Form and Instruction
BLS9300 FAX SOII Fax Form AK_2021 with DART.docx	Form and Instruction
BLS9300 FAX SOII Fax Form AK_2021 with DART.docx	Form and Instruction
BLS 9300 FAX SOII FAX Form Item 24 - Fax_form_English_2021 updated for DART.docx	Form and Instruction
BLS 9300 FAX SOII FAX Form Item 24 - Fax_form_English_2021 updated for DART.docx	Form and Instruction
BLS 9300 FAX Spani SOII Spanish FAX Form Fax_form_PR_2021_with DART.docx	Form and Instruction
BLS 9300 FAX Spani SOII Spanish FAX Form Fax_form_PR_2021_with DART.docx	Form and Instruction
IDCF SOII IDCF Screenshots OMB_IDCF_Screenshots_v3.docx	Form and Instruction
IDCF SOII IDCF Screenshots OMB_IDCF_Screenshots_v3.docx	Form and Instruction
collection voluntary pass.msg Data Collection password email	IC Document
collection voluntary pass.msg Data Collection password email	IC Document
collection voluntary 2021.msg Data Collection Email	IC Document
collection voluntary 2021.msg Data Collection Email	IC Document
prenote voluntary 2022.msg Voluntary Prenote email	IC Document
prenote voluntary 2022.msg Voluntary Prenote email	IC Document
SOII Informed Consent Letter.pdf Informed Consent Letter	IC Document
SOII Informed Consent Letter.pdf Informed Consent Letter	IC Document
Item 19 - Voluntary Public Sector Letter for Pre-Notification_2022.docx Item 19 - Voluntary Pre-note 2022	IC Document
Item 19 - Voluntary Public Sector Letter for Pre-Notification_2022.docx Item 19 - Voluntary Pre-note 2022	IC Document
Item 20 - Voluntary Public Sector Letter for data collection_2021.docx Item 20 Voluntary letter for data collection 2021	IC Document
Item 20 - Voluntary Public Sector Letter for data collection_2021.docx Item 20 Voluntary letter for data collection 2021	IC Document
Item 21 - Voluntary Public Sector Letter for NR1_2021.docx Item 21 - Voluntary NR1 2021	IC Document
Item 21 - Voluntary Public Sector Letter for NR1_2021.docx Item 21 - Voluntary NR1 2021	IC Document
Item 22 - Voluntary Public Sector Letter for NR2_2021 with fax option.docx Item 22 - Voluntary NR2 2021	IC Document
Item 22 - Voluntary Public Sector Letter for NR2_2021 with fax option.docx Item 22 - Voluntary NR2 2021	IC Document
Item 16 - 2021 Internet pamphlet.docx Item 16 2021 Internet Pamphlet	IC Document
Item 16 - 2021 Internet pamphlet.docx Item 16 2021 Internet Pamphlet	IC Document
Item 5 - 2022 Prenote Leaflet.docx Item 5 2022 Prenote Leaflet	IC Document
Item 5 - 2022 Prenote Leaflet.docx Item 5 2022 Prenote Leaflet	IC Document
prenote voluntary pass.msg Prenote voluntary password email	IC Document
prenote voluntary pass.msg Prenote voluntary password email	IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

Public Sector - Voluntary

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	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	BLS 9300	Survey of Occupational Injuries and Illnesses	SOII_SY2021_Long_Form.docx	Yes	Yes	Fillable Printable
Form and Instruction	BLS9300 FAX	SOII Fax Form	AK_2021 with DART.docx	Yes	Yes	Fillable Fileable
Instruction			Item 000 - 2021 SOII instructions sheet - Voluntary.docx	Yes	Yes	Fillable Fileable
Form and Instruction	BLS 9300 FAX	SOII FAX Form	Item 24 - Fax_form_English_2021 updated for DART.docx	Yes	Yes	Fillable Fileable
Form and Instruction	BLS 9300 FAX Spanish	SOII Spanish FAX Form	Fax_form_PR_2021_with DART.docx	Yes	Yes	Fillable Fileable
Form and Instruction	IDCF	SOII IDCF Screenshots	OMB_IDCF_Screenshots_v3.docx	Yes	Yes	Fillable Fileable

Federal Enterprise Architecture Business Reference Module

Line of Business: General Government

Subfunction: Central Records & Statistical Mgt

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 6,200

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 90 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	6,200	6,200
Annual IC Time Burden (Hours)	8,996	8,996
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Data Collection password email	collection voluntary pass.msg	07/28/2021
Data Collection Email	collection voluntary 2021.msg	07/28/2021
Voluntary Prenote email	prenote voluntary 2022.msg	07/28/2021
Informed Consent Letter	SOII Informed Consent Letter.pdf	08/21/2019
Item 19 - Voluntary Pre-note 2022	Item 19 - Voluntary Public Sector Letter for Pre-Notification_2022.docx	06/28/2021
Item 20 Voluntary letter for data collection 2021	Item 20 - Voluntary Public Sector Letter for data collection_2021.docx	06/28/2021
Item 21 - Voluntary NR1 2021	Item 21 - Voluntary Public Sector Letter for NR1_2021.docx	06/28/2021
Item 22 - Voluntary NR2 2021	Item 22 - Voluntary Public Sector Letter for NR2_2021 with fax option.docx	06/28/2021
Item 16 2021 Internet Pamphlet	Item 16 - 2021 Internet pamphlet.docx	06/28/2021
Item 5 2022 Prenote Leaflet	Item 5 - 2022 Prenote Leaflet.docx	06/28/2021
Prenote voluntary password email	prenote voluntary pass.msg	07/28/2021

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