Information Collection

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

IC 179004 under ICR 202404-1220-001 · OMB 1220-0045.

⚠️ Notice: This information collection may be referencing outdated material.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

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form BLS 9300 N06 Survey of Occupational Injuries and Ilnesses - State and Local - Mandatory	Form and Instruction
2024_Item15_SOII_IDCF_Instructions.pdf	Instruction
2024_Item15_SOII_IDCF_Instructions.pdf	Instruction
BLS 9300 N06 SOII Collection Form 2024_SOII_Long_Form.pdf	Form and Instruction
BLS 9300 N06 SOII Collection Form 2024_SOII_Long_Form.pdf	Form and Instruction
BLS 9300 SOII Collection Form Spanish 2024_Item1_SOII_Spanish_data_collection.pdf	Form and Instruction
BLS 9300 SOII Collection Form Spanish 2024_Item1_SOII_Spanish_data_collection.pdf	Form and Instruction
BLS 9300 FAX SOII FAX form 2024_Item24_SOII_fax_form_English_generic_mail.pdf	Form and Instruction
BLS 9300 FAX SOII FAX form 2024_Item24_SOII_fax_form_English_generic_mail.pdf	Form and Instruction
BLS 9300 FAX SOII FAX Form Spanish 2024_Item25_SOII_fax_form_Spanish.pdf	Form and Instruction
BLS 9300 FAX SOII FAX Form Spanish 2024_Item25_SOII_fax_form_Spanish.pdf	Form and Instruction
IDCF IDCF Collection Instrument Screenshots 2024_omb_screenshots.pdf	Form and Instruction
IDCF IDCF Collection Instrument Screenshots 2024_omb_screenshots.pdf	Form and Instruction
BLS-9300-FAX SOII 2024 FAX Form - Example Alabama 2024_SOII_Fax_form.pdf	Form and Instruction
BLS-9300-FAX SOII 2024 FAX Form - Example Alabama 2024_SOII_Fax_form.pdf	Form and Instruction
SOII_informed_consent_letter.docx SOII informed consent letter	IC Document
SOII_informed_consent_letter.docx SOII informed consent letter	IC Document
2024_Mandatory_SOII_collection.pdf 2024 Mandatory Collection Notice	IC Document
2024_Mandatory_SOII_collection.pdf 2024 Mandatory Collection Notice	IC Document
2024_Mandatory_SOII_collection_Password_Notice.pdf 2024 SOII Collection Password Notice	IC Document
2024_Mandatory_SOII_collection_Password_Notice.pdf 2024 SOII Collection Password Notice	IC Document
2025_Mandatory_SOII_Prenote.pdf 2025 Mandatory Prenote message	IC Document
2025_Mandatory_SOII_Prenote.pdf 2025 Mandatory Prenote message	IC Document
2025_Item5_SOII_Prenote_leaflet.pdf 2025 Prenote leaflet	IC Document
2025_Item5_SOII_Prenote_leaflet.pdf 2025 Prenote leaflet	IC Document
2024_Item17_SOII_NR1_letter.pdf Item 17 Nonresponse letter 1	IC Document
2024_Item17_SOII_NR1_letter_rev.pdf Item 17 Nonresponse letter 1	IC Document
2024_Item18_SOII_NR2_letter.pdf Item 18 Nonresponse letter 2	IC Document
2024_Item18_SOII_NR2_letter_rev.pdf Item 18 Nonresponse letter 2	IC Document
2024_Item16_SOII_Internet_pamphlet.pdf 2024 Internet pamphlet	IC Document
2024_Item16_SOII_Internet_pamphlet.pdf 2024 Internet pamphlet	IC Document
2025_Item23_SOII_mandatory_prenote_letter.pdf 2025 Prenote Letter	IC Document
2025_Item23_SOII_mandatory_prenote_letter_rev.pdf 2025 Prenote Letter	IC Document
2025_Mandatory_SOII_Prenote_Password_Notice.pdf 2025 Mandatory Prenote Password Notice	IC Document
2025_Mandatory_SOII_Prenote_Password_Notice.pdf 2025 Mandatory Prenote Password Notice	IC Document
SOII_Indian_Tribal_Letter.pdf Indian Tribal Letter	IC Document
SOII_Indian_Tribal_Letter_rev.pdf Indian 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: Modified

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	BLS 9300 N06	SOII Collection Form	2024_SOII_Long_Form.pdf	Yes	Yes	Fillable Printable
Instruction			2024_Item15_SOII_IDCF_Instructions.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	BLS 9300	SOII Collection Form Spanish	2024_Item1_SOII_Spanish_data_collection.pdf	Yes	Yes	Fillable Printable
Form and Instruction	BLS 9300 FAX	SOII FAX form	2024_Item24_SOII_fax_form_English_generic_mail.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	BLS 9300 FAX	SOII FAX Form Spanish	2024_Item25_SOII_fax_form_Spanish.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	IDCF	IDCF Collection Instrument Screenshots	2024_omb_screenshots.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	BLS-9300-FAX	SOII 2024 FAX Form - Example Alabama	2024_SOII_Fax_form.pdf	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: 15,100

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 90 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	15,100	300	14,800
Annual IC Time Burden (Hours)	11,892	3,062	8,830
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
SOII informed consent letter	SOII_informed_consent_letter.docx	05/13/2024
2024 Mandatory Collection Notice	2024_Mandatory_SOII_collection.pdf	05/13/2024
2024 SOII Collection Password Notice	2024_Mandatory_SOII_collection_Password_Notice.pdf	05/13/2024
2025 Mandatory Prenote message	2025_Mandatory_SOII_Prenote.pdf	05/13/2024
2025 Prenote leaflet	2025_Item5_SOII_Prenote_leaflet.pdf	05/13/2024
Item 17 Nonresponse letter 1	2024_Item17_SOII_NR1_letter_rev.pdf	08/16/2024
Item 18 Nonresponse letter 2	2024_Item18_SOII_NR2_letter_rev.pdf	08/16/2024
2024 Internet pamphlet	2024_Item16_SOII_Internet_pamphlet.pdf	05/13/2024
2025 Prenote Letter	2025_Item23_SOII_mandatory_prenote_letter_rev.pdf	08/16/2024
2025 Mandatory Prenote Password Notice	2025_Mandatory_SOII_Prenote_Password_Notice.pdf	05/13/2024
Indian Tribal Letter	SOII_Indian_Tribal_Letter_rev.pdf	08/16/2024

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