Census of Fatal Occupational Injuries - State, local, and tribal government

Census of Fatal Occupational Injuries

OMB: 1220-0133

IC ID: 182258

Documents and Forms
Document Name
Document Type
Form
Instruction
Instruction
Instruction
Instruction
Form
Form
Information Collection (IC) Details

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Census of Fatal Occupational Injuries - State, local, and tribal government
 
No Modified
 
Voluntary
 

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 2B - Letter requesting source documents.docx Yes Yes Fillable Printable
Instruction Attachment 2C - FAX requesting death certificatesAttachment 2C.docx Yes Yes Fillable Printable

General Government Central Records & Statistical Mgt

 

260 0
   
State, Local, and Tribal Governments
 
   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 0 0 15,505
Annual IC Time Burden (Hours) 2,591 0 0 0 0 2,591
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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