Public Sector - Voluntary

Survey of Occupational Injuries and Illnesses

OMB: 1220-0045

IC ID: 192801

⚠️ Notice: This information collection may be referencing outdated material.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

Documents and Forms

Document Name Document Type
Form BLS 9300 Public Sector - Voluntary Form and Instruction
Item 000 - 2022 SOII instructions sheet - Voluntary OMB.pdf Instruction
Item 000 - 2022 SOII instructions sheet - Voluntary OMB.pdf Instruction
BLS 9300 Survey of Occupational Injuries and Illnesses SOII_SY2022_Long_Form OMB.pdf Form and Instruction
BLS 9300 Survey of Occupational Injuries and Illnesses SOII_SY2022_Long_Form OMB.pdf Form and Instruction
BLS9300 FAX SOII Fax Form AL_2022_Fax form.pdf Form and Instruction
BLS9300 FAX SOII Fax Form AL_2022_Fax form.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 Spani SOII Spanish FAX Form Item 25 - Fax_form_PR_2022 OMB.pdf Form and Instruction
BLS 9300 FAX Spani SOII Spanish FAX Form Item 25 - Fax_form_PR_2022 OMB.pdf Form and Instruction
IDCF SOII IDCF Screenshots OMB_IDCF_Screenshots_v3.docx Form and Instruction
IDCF SOII IDCF Screenshots OMB_IDCF_Screenshots_v3.docx Form and Instruction
collection voluntary pass.msg Data Collection password email IC Document
collection voluntary pass.msg Data Collection password email IC Document
collection voluntary 2022 email.msg Data Collection Email IC Document
collection voluntary 2022 email.msg Data Collection Email IC Document
prenote voluntary 2023 email.msg Voluntary Prenote email IC Document
prenote voluntary 2023 email.msg Voluntary Prenote email IC Document
SOII Informed Consent Letter.pdf Informed Consent Letter IC Document
SOII Informed Consent Letter.pdf Informed Consent Letter IC Document
Item 19 - Voluntary Public Sector Letter for Pre-Notification_2023 w Marika OMB.pdf Item 19 - Voluntary Pre-note 2022 IC Document
Item 19 - Voluntary Public Sector Letter for Pre-Notification_2023 w Marika OMB.pdf Item 19 - Voluntary Pre-note 2022 IC Document
Item 20 - Voluntary Public Sector Letter for data collection_2022 w Marika OMB.pdf Item 20 Voluntary letter for data collection 2022 IC Document
Item 20 - Voluntary Public Sector Letter for data collection_2022 w Marika OMB.pdf Item 20 Voluntary letter for data collection 2022 IC Document
Item 21 - Voluntary Public Sector Letter for NR1_2022 w Marika OMB.pdf Item 21 - Voluntary NR1 2022 IC Document
Item 21 - Voluntary Public Sector Letter for NR1_2022 w Marika OMB.pdf Item 21 - Voluntary NR1 2022 IC Document
Item 22 - Voluntary Public Sector Letter for NR2_2022 w Marika_with fax option OMB.pdf Item 22 - Voluntary NR2 2022 IC Document
Item 22 - Voluntary Public Sector Letter for NR2_2022 w Marika_with fax option OMB.pdf Item 22 - Voluntary NR2 2022 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 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
prenote voluntary pass.msg Prenote voluntary password email IC Document
prenote voluntary pass.msg Prenote voluntary password email IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Public Sector - Voluntary	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	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	BLS 9300	Survey of Occupational Injuries and Illnesses	SOII_SY2022_Long_Form OMB.pdf	Yes	Yes	Fillable Printable
Form and Instruction	BLS9300 FAX	SOII Fax Form	AL_2022_Fax form.pdf	Yes	Yes	Fillable Fileable
Instruction			Item 000 - 2022 SOII instructions sheet - Voluntary OMB.pdf	Yes	Yes	Fillable Fileable
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 Spanish	SOII Spanish FAX Form	Item 25 - Fax_form_PR_2022 OMB.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	IDCF	SOII IDCF Screenshots	OMB_IDCF_Screenshots_v3.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: 6,200	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 90 %

	Approved	Previously Approved
Annual Number of Responses for this IC	6,200	6,200
Annual IC Time Burden (Hours)	8,996	8,996
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Data Collection password email	collection voluntary pass.msg	07/28/2021
Data Collection Email	collection voluntary 2022 email.msg	07/29/2022
Voluntary Prenote email	prenote voluntary 2023 email.msg	07/29/2022
Informed Consent Letter	SOII Informed Consent Letter.pdf	08/21/2019
Item 19 - Voluntary Pre-note 2022	Item 19 - Voluntary Public Sector Letter for Pre-Notification_2023 w Marika OMB.pdf	07/29/2022
Item 20 Voluntary letter for data collection 2022	Item 20 - Voluntary Public Sector Letter for data collection_2022 w Marika OMB.pdf	07/27/2022
Item 21 - Voluntary NR1 2022	Item 21 - Voluntary Public Sector Letter for NR1_2022 w Marika OMB.pdf	07/27/2022
Item 22 - Voluntary NR2 2022	Item 22 - Voluntary Public Sector Letter for NR2_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
Item 5 2022 Prenote Leaflet	Item 5 - 2023 Prenote Leaflet OMB.pdf	07/29/2022
Prenote voluntary password email	prenote voluntary pass.msg	07/28/2021

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