Information Collection

Estimated Respondent (State Consultation Programs) Hour and Cost Burden for Pilot Study

IC 252096 under ICR 202501-1218-004 · OMB 1218-0280.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form Form 33 Estimated Respondent (State Consultation Programs) Hour and Cost Burden for Pilot Study	Form and Instruction
Form Form 33 On Site Consultation Progam Safety and Health Assessment Worksheet (OSHA Form 33) Estimated Respondent (State Consultation Programs) Hour and Cost Burden for Pilot Study	Form and Instruction
Form 33 On Site Consultation Progam Safety and Health Assessment 1218-0280 Form 33 -OSHA 3.2025.docx	Form and Instruction
Form 33 On Site Consultation Progam Safety and Health Assessment 1218-0280 Form 33 -OSHA 3.2025.docx	Form and Instruction

IC Title:

Agency IC Tracking Number:

1218-0280 (2025)

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation: 29 CFR 1908.6 (e)(3) 29 CFR 1908.6 (g)(l) 29 CFR 1908.6 (e)(8)

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	Form 33				No		Printable Only

Line of Business: Workforce Management

Subfunction: Worker Safety

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 23

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	157	-1,014	1,171
Annual IC Time Burden (Hours)	650	-4,010	4,660
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

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

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