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Reporting Occupational Injuries and Illnesses
Recordkeeping and Reporting Occupational Injuries and Illnesses (29 CFR Part 1904)
OMB: 1218-0176
IC ID: 212582
OMB.report
DOL/OSHA
OMB 1218-0176
ICR 202201-1218-008
IC 212582
( )
Documents and Forms
Document Name
Document Type
Form OSHA 6-40.1
Reporting Occupational Injuries and Illnesses
Form and Instruction
OSHA 6-40.1 Serious Event Reporting Online Form
Serious Event Reporting Online Form _ Occupational Safety and Health Administration (downloaded 01.18.19).pdf
www.osha.gov/pls/ser/serform.html
Form and Instruction
OSHA 6-40.1 Serious Event Reporting Online Form
Serious Event Reporting Online Form _ Occupational Safety and Health Administration (downloaded 01.18.19).pdf
www.osha.gov/pls/ser/serform.html
Form and Instruction
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Reporting Occupational Injuries and Illnesses
Agency IC Tracking Number:
1218-0176(2022)
Is this a Common Form?
No
IC Status:
Modified
Obligation to Respond:
Mandatory
CFR Citation:
29 CFR 1904.39
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form and Instruction
OSHA 6-40.1
Serious Event Reporting Online Form
Serious Event Reporting Online Form _ Occupational Safety and Health Administration (downloaded 01.18.19).pdf
https://www.osha.gov/pls/ser/serform.html
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Workforce Management
Subfunction:
Worker Safety
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
20,000
Number of Respondents for Small Entity:
0
Affected Public:
Private Sector
Private Sector:
Businesses or other for-profits
Percentage of Respondents Reporting Electronically:
100 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
20,000
0
0
0
0
20,000
Annual IC Time Burden (Hours)
10,000
0
0
0
0
10,000
Annual IC Cost Burden (Dollars)
0
0
0
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.
