Information Collection

Estimated Respondent (State Consultation Programs) Hour and Cost Burden for Pilot Study

IC 252096 under ICR 202202-1218-002 · OMB 1218-0280.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1218-0280 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 33 Estimated Respondent (State Consultation Programs) Hour and Cost Burden for Pilot Study	Form and Instruction
33 On Site Consultation Progam Safety and Health Assessment Draft Revised Form 33 -OSBA no tracked changes 4-28-22 PRA.docx	Form and Instruction
33 On Site Consultation Progam Safety and Health Assessment Draft Revised Form 33 -OSBA no tracked changes 4-28-22 PRA.docx	Form and Instruction

IC Title:

Estimated Respondent (State Consultation Programs) Hour and Cost Burden for Pilot Study

Agency IC Tracking Number:

1218-0NEW (2022)

Is this a Common Form? No

IC Status: New

Obligation to Respond: Voluntary

CFR Citation: 29 CFR 1908.6 (e)(3) 29 CFR 1908.6 (e)(8) 29 CFR 1908.6 (g)(l)

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	33	On Site Consultation Progam Safety and Health Assessment Worksheet (OSHA Form 33)	Draft Revised Form 33 -OSBA no tracked changes 4-28-22 PRA.docx		No		Printable Only

Line of Business: Workforce Management

Subfunction: Worker Safety

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 200

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	1,171	1,171
Annual IC Time Burden (Hours)	4,660	4,660
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
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.