Information Collection

Field Test for Safety and Health Programs

IC 254342 under ICR 202312-1225-001 · OMB 1225-0088.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1225-0088 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form Field Test 1 Field Test for Safety and Health Programs	Form and Instruction
Field Test 1 Field Test - SHP Step-by-Step Guide - Feedback Questions Field Test - SHP Step-by-Step Guide - Feedback Questions 6.17.22.docx	Form and Instruction
Field Test 1 Field Test - SHP Step-by-Step Guide - Feedback Questions Field Test - SHP Step-by-Step Guide - Feedback Questions 6.17.22.docx	Form and Instruction
Justification - Request for Approval OMB Control Number 1225-0088.docx Field Test for Safety and Health Programs Mini Supporting Statement	IC Document
Justification - Request for Approval OMB Control Number 1225-0088.docx Field Test for Safety and Health Programs Mini Supporting Statement	IC Document

IC Title:

Field Test for Safety and Health Programs

Agency IC Tracking Number:

IC Status: Unchanged

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	Field Test 1	Field Test - SHP Step-by-Step Guide - Feedback Questions	Field Test - SHP Step-by-Step Guide - Feedback Questions 6.17.22.docx		Yes	Yes	Fillable Fileable

Line of Business: Workforce Management

Subfunction: Worker Safety

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 500

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Requested	Previously Approved
Annual Number of Responses for this IC	500	500
Annual IC Time Burden (Hours)	58	58
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Field Test for Safety and Health Programs Mini Supporting Statement	Justification - Request for Approval OMB Control Number 1225-0088.docx	06/23/2022

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