Information Collection

Safety Champions Program Participant

IC 213271 under ICR 202603-1218-001 · OMB 1218-0239.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
SCP Sign up Safety Champions Program Participant	Form
SCP Sign up Safety Champions Sign up Form _03-06-2026.pdf www.osha.gov/safety-champions/registration	Form

IC Title:

Agency IC Tracking Number:

1218-0239(2024)

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

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	N/A			https://www.osha.gov/safety-champions/registration	Yes	Yes	Fillable Fileable

Line of Business: Workforce Management

Subfunction: Worker Safety

Privacy Act System of Records

Title: DOL/OSHA-6

FR Citation: 81 FR 25766

Number of Respondents: 60

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 15 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	60	60
Annual IC Time Burden (Hours)	990	990
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].