Census of Fatal Occupational Injuries - State, local, and tribal government

Census of Fatal Occupational Injuries

Documents and Forms

Document Name Document Type
Form CFOI 1 Census of Fatal Occupational Injuries - State, local, and tribal government Form
2025_CFOI_Attachment2B_Letter_requesting_source_documents.docx Instruction
CFOI 1 Census of Fatal Occupational Injuries Report 2025_CFOI-1_Final.docx Form
Attachment 2C FAX requesting death certificates 2025_CFOI_Attachment2C_FAX_requesting_death_certificates.docx Form and Instruction

Information Collection (IC) Details

IC Title:	Census of Fatal Occupational Injuries - State, local, and tribal government	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	CFOI 1	Census of Fatal Occupational Injuries Report	2025_CFOI-1_Final.docx	Yes	No	Fillable Printable
Instruction			2025_CFOI_Attachment2B_Letter_requesting_source_documents.docx	Yes	No	Printable Only
Form and Instruction	Attachment 2C	FAX requesting death certificates	2025_CFOI_Attachment2C_FAX_requesting_death_certificates.docx	Yes	Yes	Fillable Fileable

Line of Business: General Government

Subfunction: Central Records & Statistical Mgt

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 240	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

	Requested	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	15,876	371	15,505
Annual IC Time Burden (Hours)	2,650	59	2,591
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

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.