Notice of Alleged Safety or Health Hazards (OSHA-7 Form)

Forms and Documents

Document Name	Status
Form OSHA-7 (Enlish, do Notice of Alleged Safety or Health Hazards (OSHA-7 Form) Form and Instruction	Modified
29 CFR 1903.11.docx Supplementary Document	2024-07-03
29_U.S.C._651.pdf Supplementary Document	2024-07-03
29 USC 657.pdf Supplementary Document	2024-07-03
60 - Day FRN _ April 30 2024.pdf Supplementary Document	2024-07-03
SS_OSHA 7 Complaint Form_1218-0064_07-22-2024_ROCIS.docx Supporting Statement A	2024-07-22

IC Document Collections

IC ID	Document Title	Status
13971	Notice of Alleged Safety or Health Hazards (OSHA-7 Form) Form and Instruction	Modified

ICR Details

OMB Control No: 1218-0064	ICR Reference No: 202407-1218-004
Status: Received in OIRA	Previous ICR Reference No: 202201-1218-010
Agency/Subagency: DOL/OSHA	Agency Tracking No: 1218-0064 (2024)
Title: Notice of Alleged Safety or Health Hazards (OSHA-7 Form)
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular	Date Submitted to OIRA: 07/24/2024

	Requested	Previously Approved
Expiration Date	36 Months From Approved	07/31/2024
Responses	120,183	76,036
Time Burden (Hours)	35,783	21,171
Cost Burden (Dollars)	1,705	336

---

Abstract: The OSHA-7 Form is used by OSHA personnel to report unhealthful and/or unsafe conditions in the workplace. The information is given to OSHA by employees who wish to report unhealthful and/or unsafe conditions at their place of employment. Employee reports are authorized by Section 8(f)(1) of the OSH Act. This information is used by OSHA to evaluate the alleged hazards and to schedule an inspection. The form is available in English and Spanish.

---

Authorizing Statute(s): US Code: 29 USC 651 Name of Law: Occupational Safety and Health Act
   US Code: 29 USC 657 Name of Law: Occupational Safety and Health Act
  

Citations for New Statutory Requirements: None

---

Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

---

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	89 FR 34273	04/30/2024
30-day Notice:	Federal Register Citation:	Citation Date:
	89 FR 59938	07/24/2024
Did the Agency receive public comments on this ICR? No

---

Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
Notice of Alleged Safety or Health Hazards (OSHA-7 Form)	OSHA-7 (English, online), OSHA-7 (Spanish, online), OSHA-7 (Enlish, downloadable), OSHA-7 (Spanish, downloadable)	Notice of Alleged Safety and Health Hazards (downloadable) ,   Notificación de una Queja en Seguridad y Salud ,   OSHA Online Complaint Form - Notice of Alleged Safety and Health Hazard ,   Notificacion de Alegacion de Riesgos a la Seguridad o Salud

---

ICR Summary of Burden

	Total Request	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	120,183	76,036	0	0	44,147	0
Annual Time Burden (Hours)	35,783	21,171	0	0	14,612	0
Annual Cost Burden (Dollars)	1,705	336	0	0	1,369	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: The agency is requesting an adjustment increase of 14,612 burden hours (from 21,171 to 35,783 hours). The increase is due to an increase in the number of estimated OSHA-7 complaint forms submitted, from 68,896 to 94,529.

---

Annual Cost to Federal Government: $584,348

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     No

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? No

---

Common Form ICR:  No

---

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 07/24/2024

---