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

IC 182258 under ICR 202503-1220-004 · OMB 1220-0133.

Documents and Forms
Document Name
Document Type
Form
Form
Form and Instruction
Instruction
Instruction
Form
Form
Form and Instruction
Form and Instruction
Information Collection (IC) Details

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Census of Fatal Occupational Injuries - State, local, and tribal government
 
No Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL 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

General Government Central Records & Statistical Mgt

 

240 0
   
State, Local, and Tribal Governments
 
   0 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 15,876 0 371 0 0 15,505
Annual IC Time Burden (Hours) 2,650 0 59 0 0 2,591
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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