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

Survey of Occupational Injuries and Illnesses

OMB: 1220-0045

IC ID: 179004

⚠️ Notice: This information collection may be referencing outdated material.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

2024-07-01 - Revision of a currently approved collection

Documents and Forms

Document Name Document Type
Form BLS 9300 FAX Survey of Occupational Injuries and Ilnesses - State and Local - Mandatory Form and Instruction
Item 15 - 2023 IDCF - Instructions OMB.pdf Instruction
Item 15 - 2023 IDCF - Instructions OMB.pdf Instruction
BLS 9300 FAX SOII FAX form AL_2023_Fax form OMB.pdf Form and Instruction
BLS 9300 FAX SOII FAX form AL_2023_Fax form OMB.pdf Form and Instruction
BLS 9300 Survey of Occupational Injuries and Illnesses 2021 SOII_SY2023_Long_Form OMB.pdf Form and Instruction
BLS 9300 Survey of Occupational Injuries and Illnesses 2021 SOII_SY2023_Long_Form OMB.pdf Form and Instruction
Form 9300 SOII Spanish Data Collection Book Item 1 - 2023 SOII Spanish Data Collection Book OMB.pdf Form and Instruction
Form 9300 SOII Spanish Data Collection Book Item 1 - 2023 SOII Spanish Data Collection Book OMB.pdf Form and Instruction
BLS 9300 FAX SOII Fax Form Item 24 - Fax form English 2023 generic OMB.pdf Form and Instruction
BLS 9300 FAX SOII Fax Form Item 24 - Fax form English 2023 generic OMB.pdf Form and Instruction
BLS 9300 Fax SOII Fax Form Spanish Item 25 - Fax form PR 2023 OMB.pdf Form and Instruction
BLS 9300 Fax SOII Fax Form Spanish Item 25 - Fax form PR 2023 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
Mandatory 2023_Password_Notice_OMB.pdf Data Collection password email IC Document
Mandatory 2023_Password_Notice_OMB.pdf Data Collection password email IC Document
Mandatory Prenote 2024 Survey of Occupational Injuries and Illnesses OMB.pdf Mandatory prenote email message IC Document
Mandatory Prenote 2024 Survey of Occupational Injuries and Illnesses OMB.pdf Mandatory prenote email message IC Document
Mandatory 2023_Survey of Occupational Injuries and Illnesses - OMB.pdf Data Collection email message IC Document
Mandatory 2023_Survey of Occupational Injuries and Illnesses - OMB.pdf Data Collection email message IC Document
Item 5 - 2024 Prenote Leaflet OMB.pdf Item 5 2022 Prenote Leaflet IC Document
Item 5 - 2024 Prenote Leaflet OMB.pdf Item 5 2022 Prenote Leaflet IC Document
Item 17 - Non-Response letter 1 2023 OMB.pdf Item 17 Non Response Letter 1 2022 IC Document
Item 17 - Non-Response letter 1 2023 OMB.pdf Item 17 Non Response Letter 1 2022 IC Document
Item 18 - Non-Response letter 2 2023 with fax option OMB.pdf Item 18 Nonresponse Letter 2 IC Document
Item 18 - Non-Response letter 2 2023 with fax option OMB.pdf Item 18 Nonresponse Letter 2 IC Document
Item 16 - 2023 Internet pamphlet OMB.pdf Item 16 - 2021 Internet Pamphlet IC Document
Item 16 - 2023 Internet pamphlet OMB.pdf Item 16 - 2021 Internet Pamphlet IC Document
Item 23 - Mandatory Letter for Pre-Notification 2024 OMB.pdf Ite 23 - Mandatory Pre-Note 2022 IC Document
Item 23 - Mandatory Letter for Pre-Notification 2024 OMB.pdf Ite 23 - Mandatory Pre-Note 2022 IC Document
Mandatory Prenote 2024_Password_Notice_OMB.pdf Prenote manadatory password email IC Document
Mandatory Prenote 2024_Password_Notice_OMB.pdf 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: Unchanged

Obligation to Respond: Mandatory

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 FAX	SOII FAX form	AL_2023_Fax form OMB.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	BLS 9300	Survey of Occupational Injuries and Illnesses 2021	SOII_SY2023_Long_Form OMB.pdf	Yes	Yes	Fillable Printable
Instruction			Item 15 - 2023 IDCF - Instructions OMB.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	Form 9300	SOII Spanish Data Collection Book	Item 1 - 2023 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 2023 generic OMB.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	BLS 9300 Fax	SOII Fax Form Spanish	Item 25 - Fax form PR 2023 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 %

	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

Title	Document	Date Uploaded
SOII Informed consent letter	SOII Informed Consent Letter.pdf	08/21/2019
Data Collection password email	Mandatory 2023_Password_Notice_OMB.pdf	08/01/2023
Mandatory prenote email message	Mandatory Prenote 2024 Survey of Occupational Injuries and Illnesses OMB.pdf	07/31/2023
Data Collection email message	Mandatory 2023_Survey of Occupational Injuries and Illnesses - OMB.pdf	08/01/2023
Item 5 2022 Prenote Leaflet	Item 5 - 2024 Prenote Leaflet OMB.pdf	07/31/2023
Item 17 Non Response Letter 1 2022	Item 17 - Non-Response letter 1 2023 OMB.pdf	07/31/2023
Item 18 Nonresponse Letter 2	Item 18 - Non-Response letter 2 2023 with fax option OMB.pdf	07/31/2023
Item 16 - 2021 Internet Pamphlet	Item 16 - 2023 Internet pamphlet OMB.pdf	07/31/2023
Ite 23 - Mandatory Pre-Note 2022	Item 23 - Mandatory Letter for Pre-Notification 2024 OMB.pdf	07/31/2023
Prenote manadatory password email	Mandatory Prenote 2024_Password_Notice_OMB.pdf	08/01/2023
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.