Information Collection

Reporting Occupational Injuries and Illnesses

IC 212582 under ICR 202509-1218-002 · OMB 1218-0176.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form OSHA 6-40.1 Reporting Occupational Injuries and Illnesses	Form and Instruction
Form OSHA 6-40.1 Serious Event Reporting Online Form Reporting Occupational Injuries and Illnesses	Form and Instruction
OSHA 6-40.1 Serious Event Reporting Online Form Serious Event Reporting Online Form _ Occupational Safety and Health Administration (downloaded 01.18.19).pdf www.osha.gov/pls/ser/serform.html	Form and Instruction
OSHA 6-40.1 Serious Event Reporting Online Form Serious Event Reporting Online Form _ Occupational Safety and Health Administration (downloaded 01.18.19).pdf www.osha.gov/pls/ser/serform.html	Form and Instruction

IC Title:

Agency IC Tracking Number:

1218-0176(2025)

Is this a Common Form? No

IC Status: Unchanged

Obligation to Respond: Mandatory

CFR Citation: 29 CFR 1904.39

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	OSHA 6-40.1			https://www.osha.gov/pls/ser/serform.html	Yes	Yes	Fillable Fileable

Line of Business: Workforce Management

Subfunction: Worker Safety

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 20,000

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	20,000	20,000
Annual IC Time Burden (Hours)	10,000	10,000
Annual IC Cost Burden (Dollars)	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.

Something went wrong when downloading this file. If you have any questions, please send an email to [email protected].