Public Sector - Voluntary

Survey of Occupational Injuries and Illnesses

OMB: 1220-0045

IC ID: 192801

⚠️ Notice: This information collection may be referencing outdated material.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

2023-11-06 - No material or nonsubstantive change to a currently approved collection
2023-08-01 - No material or nonsubstantive change to a currently approved collection

Documents and Forms

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:

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 %

	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

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.