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Census of Fatal Occupational Injuries - State, local, and tribal government
Census of Fatal Occupational Injuries
OMB: 1220-0133
IC ID: 182258
OMB.report
DOL/BLS
OMB 1220-0133
ICR 202206-1220-001
IC 182258
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1220-0133 can be found here:
2023-01-12 - No material or nonsubstantive change to a currently approved collection
Documents and Forms
Document Name
Document Type
Form CFOI-1
Census of Fatal Occupational Injuries - State, local, and tribal government
Form
Attachment 2B - Letter requesting source documents.docx
Instruction
Attachment 2B - Letter requesting source documents.docx
Instruction
Attachment 2C - FAX requesting death certificatesAttachment 2C.docx
Instruction
Attachment 2C - FAX requesting death certificatesAttachment 2C.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
View Information Collection (IC)
IC Title:
Census of Fatal Occupational Injuries - State, local, and tribal government
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 2B - Letter requesting source documents.docx
Yes
Yes
Fillable Printable
Instruction
Attachment 2C - FAX requesting death certificatesAttachment 2C.docx
Yes
Yes
Fillable Printable
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:
260
Number of Respondents for Small Entity:
0
Affected Public:
State, Local, and Tribal Governments
Percentage of Respondents Reporting Electronically:
0 %
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
15,505
0
0
695
0
14,810
Annual IC Time Burden (Hours)
2,591
0
0
114
0
2,477
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.