Information Collection

Survey of Occupational Injuries and Ilnesses - State and Local - Mandatory

IC 179004 under ICR 202207-1220-003 · OMB 1220-0045.

⚠️ Notice: This information collection may be referencing outdated material.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

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form BLS 9300 FAX Survey of Occupational Injuries and Ilnesses - State and Local - Mandatory	Form and Instruction
Item 15 - IDCF - Instructions 2022 OMB.pdf	Instruction
Item 15 - IDCF - Instructions 2022 OMB.pdf	Instruction
BLS 9300 FAX SOII FAX form AL_2022_Fax form.pdf	Form and Instruction
BLS 9300 FAX SOII FAX form AL_2022_Fax form.pdf	Form and Instruction
BLS 9300 Survey of Occupational Injuries and Illnesses 2021 SOII_SY2022_Long_Form OMB.pdf	Form and Instruction
BLS 9300 Survey of Occupational Injuries and Illnesses 2021 SOII_SY2022_Long_Form OMB.pdf	Form and Instruction
Form 9300 SOII Spanish Data Collection Book Item 1 - 2022 SOII Spanish Data Collection Book OMB.pdf	Form and Instruction
Form 9300 SOII Spanish Data Collection Book Item 1 - 2022 SOII Spanish Data Collection Book OMB.pdf	Form and Instruction
BLS 9300 FAX SOII Fax Form Item 24 - Fax_form_English_2022 generic OMB.pdf	Form and Instruction
BLS 9300 FAX SOII Fax Form Item 24 - Fax_form_English_2022 generic OMB.pdf	Form and Instruction
BLS 9300 Fax SOII Fax Form Spanish Item 25 - Fax_form_PR_2022 OMB.pdf	Form and Instruction
BLS 9300 Fax SOII Fax Form Spanish Item 25 - Fax_form_PR_2022 OMB.pdf	Form and Instruction
IDCF SOII IDCF Screenshots OMB_IDCF_Screenshots_20210726.docx	Form and Instruction
IDCF SOII IDCF Screenshots OMB_IDCF_Screenshots_20210726.docx	Form and Instruction
SOII Informed Consent Letter.pdf SOII Informed consent letter	IC Document
SOII Informed Consent Letter.pdf SOII Informed consent letter	IC Document
collection mandatory pass.msg Data Collection password email	IC Document
collection mandatory pass.msg Data Collection password email	IC Document
prenote mandatory 2023 email.msg Mandatory prenote email message	IC Document
prenote mandatory 2023 email.msg Mandatory prenote email message	IC Document
collection mandatory 2022 email.msg Data Collection email message	IC Document
collection mandatory 2022 email.msg Data Collection email message	IC Document
Item 5 - 2023 Prenote Leaflet OMB.pdf Item 5 2022 Prenote Leaflet	IC Document
Item 5 - 2023 Prenote Leaflet OMB.pdf Item 5 2022 Prenote Leaflet	IC Document
Item 17 - Non-Response letter 1_2022 w Marika OMB.pdf Item 17 Non Response Letter 1 2022	IC Document
Item 17 - Non-Response letter 1_2022 w Marika OMB.pdf Item 17 Non Response Letter 1 2022	IC Document
Item 18 - Non-Response letter 2_2022 w Marika_with fax option OMB.pdf Item 18 Nonresponse Letter 2	IC Document
Item 18 - Non-Response letter 2_2022 w Marika_with fax option OMB.pdf Item 18 Nonresponse Letter 2	IC Document
Item 16 - 2022 Internet pamphlet OMB.pdf Item 16 - 2021 Internet Pamphlet	IC Document
Item 16 - 2022 Internet pamphlet OMB.pdf Item 16 - 2021 Internet Pamphlet	IC Document
Item 23 - Mandatory Pre-Notification_2022.docx Ite 23 - Mandatory Pre-Note 2022	IC Document
Item 23 - Mandatory Pre-Notification_2022.docx Ite 23 - Mandatory Pre-Note 2022	IC Document
prenote mandatory pass.msg Prenote manadatory password email	IC Document
prenote mandatory pass.msg Prenote manadatory password email	IC Document
Indian_Tribal_Letter_2021 Final.docx Tribal Letter	IC Document
Indian_Tribal_Letter_2021 Final.docx Tribal Letter	IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

Survey of Occupational Injuries and Ilnesses - State and Local - Mandatory

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	BLS 9300 FAX	SOII FAX form	AL_2022_Fax form.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	BLS 9300	Survey of Occupational Injuries and Illnesses 2021	SOII_SY2022_Long_Form OMB.pdf	Yes	Yes	Fillable Printable
Instruction			Item 15 - IDCF - Instructions 2022 OMB.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	Form 9300	SOII Spanish Data Collection Book	Item 1 - 2022 SOII Spanish Data Collection Book OMB.pdf	Yes	Yes	Fillable Printable
Form and Instruction	BLS 9300 FAX	SOII Fax Form	Item 24 - Fax_form_English_2022 generic OMB.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	BLS 9300 Fax	SOII Fax Form Spanish	Item 25 - Fax_form_PR_2022 OMB.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	IDCF	SOII IDCF Screenshots	OMB_IDCF_Screenshots_20210726.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: 14,800

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 90 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	14,800	14,800
Annual IC Time Burden (Hours)	8,830	8,830
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
SOII Informed consent letter	SOII Informed Consent Letter.pdf	08/21/2019
Data Collection password email	collection mandatory pass.msg	07/28/2021
Mandatory prenote email message	prenote mandatory 2023 email.msg	07/29/2022
Data Collection email message	collection mandatory 2022 email.msg	07/29/2022
Item 5 2022 Prenote Leaflet	Item 5 - 2023 Prenote Leaflet OMB.pdf	07/27/2022
Item 17 Non Response Letter 1 2022	Item 17 - Non-Response letter 1_2022 w Marika OMB.pdf	07/27/2022
Item 18 Nonresponse Letter 2	Item 18 - Non-Response letter 2_2022 w Marika_with fax option OMB.pdf	07/27/2022
Item 16 - 2021 Internet Pamphlet	Item 16 - 2022 Internet pamphlet OMB.pdf	07/27/2022
Ite 23 - Mandatory Pre-Note 2022	Item 23 - Mandatory Pre-Notification_2022.docx	06/28/2021
Prenote manadatory password email	prenote mandatory pass.msg	07/28/2021
Tribal Letter	Indian_Tribal_Letter_2021 Final.docx	12/16/2021

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.