Census of Fatal Occupational Injuries - Individuals

Census of Fatal Occupational Injuries

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1220-0133 can be found here:

Documents and Forms

Document Name Document Type
Form CFOI-1 Census of Fatal Occupational Injuries - Individuals Form
Attachment 2A - Followback questionnaire - individuals.docx Instruction
Attachment 2A - Followback questionnaire - individuals.docx Instruction
CFOI-1 Census of Fatal Occupational Injuries Report CFOI-1.docx Form
CFOI-1 Census of Fatal Occupational Injuries Report CFOI-1.docx Form

Information Collection (IC) Details

IC Title:	Census of Fatal Occupational Injuries - Individuals	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	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	CFOI-1	Census of Fatal Occupational Injuries Report	CFOI-1.docx		Yes	Yes	Fillable Printable
Instruction			Attachment 2A - Followback questionnaire - individuals.docx		Yes	Yes	Fillable Printable

Line of Business: General Government

Subfunction: Central Records & Statistical Mgt

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 41	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	41	-339	380
Annual IC Time Burden (Hours)	14	-113	127
Annual IC Cost Burden (Dollars)	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.