Occupational Safety and Health Administration Alliance Program

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form OSHA 12-10.10 Ambassador Document	Form	Modified	Available
Form OSHA 12-10.9b Annual Alliance Evaluation - Regional and Area Office	Form	Modified	Available
Form OSHA 12-10.9a Annual Alliance Evaluation - Nation Office	Form	Modified	Available
Form OSHA 12-10.7 Biannual Data Reporting Form	Form	Modified	Available
Form OSHA 12-10.6 Consulate Alliance Template - Other Countries (Spanish)	Form	Modified	Available
Form OSHA 12-10.5 Consulate Alliance Template - Mexico (Spanish)	Form	Modified	Available
Form OSHA 12-10.5 Consulate Alliance Template - Mexico (English)	Form	Modified	Available
Form OSHA 12-10.2b Reginal Area Office Renewal Agreement	Form	Modified	Available
Form OSHA 12-10.2a Reginal Area Office Agreement	Form	Modified	Available
Form OSHA 12-10.1b National Alliance Renewal Agreement	Form	Modified	Available
Form OSHA 12-10.1a National Alliance Agreement	Form	Modified	Available
Form OSHA 12-10.8 Alliance Feedback Questionnaire	Form	Modified	Available
Form OSHA 12-10.6 Consulate Alliance Template (Other Countries)	Form	Modified	Available
Form OSHA 12-10.6 OSHA's Alliance Program (Public Sector)	Form	Modified	Repair queued
Form OSHA 12-10.10 Alliance Program Ambassador	Form	Modified	Available
Form OSHA 12-10.9b Annual Alliance Evaluation - Regional and Area Office	Form	Modified	Available
Form OSHA 12-10.9a Annual Alliance Evaluation Template	Form	Modified	Available
Form OSHA 12-10.7 Biannual Data Reporting Form	Form	Modified	Available
Form OSHA 12-10.6 Consulate Alliance Template - Mexico (Spanish)	Form	Modified	Available
Form OSHA 12-10.5 Consulate Alliance Template - Mexico (Spanish)	Form	Modified	Available
Form OSHA 12-10.5 Consulate Alliance Template - Mexico (English)	Form	Modified	Available
Form OSHA 12-10.2b Reginal Area Office Renewal Agreement	Form	Modified	Available
Form OSHA 12-10.2a Reginal Area Office Agreement	Form	Modified	Available
Form OSHA 12-10.1b National Alliance Renewal Agreement	Form	Modified	Available
Form OSHA 12-10.1a National Alliance Agreement	Form	Modified	Available
Form OSHA 12-10.8 Alliance Feedback Questionnaire	Form	Modified	Repair queued
Form OSHA 12-10.6 Consulate Alliance Template (Other Countries)	Form	Modified	Available
Form OSHA 12-10.6 OSHA's Alliance Program (Private Sector)	Form	Modified	Repair queued
Attachment A.docx	Supplementary Document	Uploaded 2023-01-12	Repair queued
Alliance Product and Other Project Guidelines (6-28-18).docx	Supplementary Document	Uploaded 2023-01-12	Repair queued
60_Day FRN _9262022.pdf	Supplementary Document	Uploaded 2023-01-11	Available
OSH Act Section 2 USC 651(1-21).pdf	Supplementary Document	Uploaded 2023-01-11	Repair queued
SS _1218-0274 - OSHA's Alliance Program_02-09-2023_ROCIS.docx	Supporting Statement A	Uploaded 2023-02-09	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
234835	OSHA's Alliance Program (Public Sector)	Form	Modified	Ambassador Document
234835	OSHA's Alliance Program (Public Sector)	Form	Modified	Annual Alliance Evaluation - Regional and Area Office
234835	OSHA's Alliance Program (Public Sector)	Form	Modified	Annual Alliance Evaluation - Nation Office
234835	OSHA's Alliance Program (Public Sector)	Form	Modified	Biannual Data Reporting Form
234835	OSHA's Alliance Program (Public Sector)	Form	Modified	Consulate Alliance Template - Other Countries (Spanish)
234835	OSHA's Alliance Program (Public Sector)	Form	Modified	Consulate Alliance Template - Mexico (Spanish)
234835	OSHA's Alliance Program (Public Sector)	Form	Modified	Consulate Alliance Template - Mexico (English)
234835	OSHA's Alliance Program (Public Sector)	Form	Modified	Reginal Area Office Renewal Agreement
234835	OSHA's Alliance Program (Public Sector)	Form	Modified	Reginal Area Office Agreement
234835	OSHA's Alliance Program (Public Sector)	Form	Modified	National Alliance Renewal Agreement
234835	OSHA's Alliance Program (Public Sector)	Form	Modified	National Alliance Agreement
234835	OSHA's Alliance Program (Public Sector)	Form	Modified	Alliance Feedback Questionnaire
234835	OSHA's Alliance Program (Public Sector)	Form	Modified	Consulate Alliance Template (Other Countries)
234835	OSHA's Alliance Program (Public Sector)	Form	Modified
234833	OSHA's Alliance Program (Private Sector)	Form	Modified	Alliance Program Ambassador
234833	OSHA's Alliance Program (Private Sector)	Form	Modified	Annual Alliance Evaluation - Regional and Area Office
234833	OSHA's Alliance Program (Private Sector)	Form	Modified	Annual Alliance Evaluation Template
234833	OSHA's Alliance Program (Private Sector)	Form	Modified	Biannual Data Reporting Form
234833	OSHA's Alliance Program (Private Sector)	Form	Modified	Consulate Alliance Template - Mexico (Spanish)
234833	OSHA's Alliance Program (Private Sector)	Form	Modified	Consulate Alliance Template - Mexico (Spanish)
234833	OSHA's Alliance Program (Private Sector)	Form	Modified	Consulate Alliance Template - Mexico (English)
234833	OSHA's Alliance Program (Private Sector)	Form	Modified	Reginal Area Office Renewal Agreement
234833	OSHA's Alliance Program (Private Sector)	Form	Modified	Reginal Area Office Agreement
234833	OSHA's Alliance Program (Private Sector)	Form	Modified	National Alliance Renewal Agreement
234833	OSHA's Alliance Program (Private Sector)	Form	Modified	National Alliance Agreement
234833	OSHA's Alliance Program (Private Sector)	Form	Modified	Alliance Feedback Questionnaire
234833	OSHA's Alliance Program (Private Sector)	Form	Modified	Consulate Alliance Template (Other Countries)
234833	OSHA's Alliance Program (Private Sector)	Form	Modified

ICR Details

OMB Control No: 1218-0274	ICR Reference No: 202301-1218-001
Status: Historical Active	Previous ICR Reference No: 201902-1218-001
Agency/Subagency: DOL/OSHA	Agency Tracking No: 1218-0274 (2023)
Title: Occupational Safety and Health Administration Alliance Program
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 03/28/2023
Retrieve Notice of Action (NOA)	Date Received in OIRA: 02/15/2023
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	03/31/2026	36 Months From Approved	03/31/2023
Responses	4,968	0	4,993
Time Burden (Hours)	14,318	0	14,122
Cost Burden (Dollars)	0	0	0

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Abstract: OSHA's Alliance Program is a structure for working with groups that are committed to worker safety and health. The program enables OSHA to enter into a voluntary cooperative relationship with industry, labor and other groups to improve workplace safety and health, prevent workplace fatalities, injuries and illnesses, and to reach employers and workers that OSHA may not otherwise reach through traditional methods. OSHA collects information from organizations that are signatories to an Alliance agreement through meetings, informal conversations and data forms. OSHA will use the collected information to develop Alliance agreements, support Alliance activities and Alliance agreement objectives, and develop annual and program-wide reports.

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Authorizing Statute(s): US Code: 29 USC 651 Name of Law: Occupational Safety and Health Act
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	87 FR 58377	09/26/2022
30-day Notice:	Federal Register Citation:	Citation Date:
	88 FR 9910	02/15/2023
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 2

table that charts list of burden

IC Title	Form No.	Form Name
OSHA's Alliance Program (Private Sector)	OSHA 12-10.9a, OSHA 12-10.9b, OSHA 12-10.6, OSHA 12-10.10, OSHA 12-10.1a, OSHA 12-10.1b, OSHA 12-10.2a, OSHA 12-10.2b, OSHA 12-10.5, OSHA 12-10.5, OSHA 12-10.6, OSHA 12-10.7, OSHA 12-10.8	Consulate Alliance Template (Other Countries) ,   Alliance Feedback Questionnaire ,   National Alliance Agreement ,   National Alliance Renewal Agreement ,   Reginal Area Office Agreement ,   Reginal Area Office Renewal Agreement ,   Consulate Alliance Template - Mexico (English) ,   Consulate Alliance Template - Mexico (Spanish) ,   Consulate Alliance Template - Mexico (Spanish) ,   Biannual Data Reporting Form ,   Annual Alliance Evaluation Template ,   Annual Alliance Evaluation - Regional and Area Office ,   Alliance Program Ambassador
OSHA's Alliance Program (Public Sector)	OSHA 12-10.1a, OSHA 12-10.6, OSHA 12-10.8, OSHA 12-10.9a, OSHA 12-10.9b, OSHA 12-10.10, OSHA 12-10.1b, OSHA 12-10.2a, OSHA 12-10.2b, OSHA 12-10.5, OSHA 12-10.5, OSHA 12-10.6, OSHA 12-10.7	Consulate Alliance Template (Other Countries) ,   Alliance Feedback Questionnaire ,   National Alliance Agreement ,   National Alliance Renewal Agreement ,   Reginal Area Office Agreement ,   Reginal Area Office Renewal Agreement ,   Consulate Alliance Template - Mexico (English) ,   Consulate Alliance Template - Mexico (Spanish) ,   Consulate Alliance Template - Other Countries (Spanish) ,   Biannual Data Reporting Form ,   Annual Alliance Evaluation - Nation Office ,   Annual Alliance Evaluation - Regional and Area Office ,   Ambassador Document

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ICR Summary of Burden

table that charts list of burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	4,968	4,993	0	-25	0	0
Annual Time Burden (Hours)	14,318	14,122	0	122	74	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: The agency is requesting both an adjustment and a program change. The number of burden hours changed from 14,122 hours to 14,318 hours, an increase of 196 hours. The adjustment increase is due to an increase in the number field and national alliance programs established and reported. In addition, the program change is due to the agency discretion of adding two new forms and removing three of the existing forms from this collection which resulted in a decrease 25 in the number of responses.

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Annual Cost to Federal Government: $929,243

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     No

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? No

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 02/15/2023

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