Census of Fatal Occupational Injuries - Private Sector

Census of Fatal Occupational Injuries

Documents and Forms

Document Name Document Type
Form CFOI-1 Census of Fatal Occupational Injuries - Private Sector Form
Attachment 2A - Followback questionnaire - private industry.docx Instruction
Attachment 2A - Followback questionnaire - private industry.docx Instruction
CFOI-1 Census of Fatal Occupational Injuries Report CFOIS1702-FollowbackQuestionnaire_rev2023.01.10.pdf Form
CFOI-1 Census of Fatal Occupational Injuries Report CFOIS1702-FollowbackQuestionnaire_rev20230508.pdf Form

Information Collection (IC) Details

IC Title:	Census of Fatal Occupational Injuries - Private Sector	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	CFOIS1702-FollowbackQuestionnaire_rev20230508.pdf		Yes	Yes	Fillable Printable
Instruction			Attachment 2A - Followback questionnaire - private industry.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: 251	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits, Farms, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Previously Approved
Annual Number of Responses for this IC	251	251
Annual IC Time Burden (Hours)	84	84
Annual IC Cost Burden (Dollars)	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.