BLS Occupational Safety and Health Statistics Cooperative Agreement Application Package

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form FY 2027 CA OSHS FY27 Cooperative Agreement	Form and Instruction	Modified	Repair queued
Form FY 2027 CA OSHS FY27 Cooperative Agreement	Form and Instruction	Modified	Available
Form OSHS2 BLS-OSHS Quarterly Financial Report	Form	Modified	Repair queued
Form OSHS2 BLS-OSHS Quarterly Financial Report	Form	Modified	Available
Form BLS OSHS Property BLS OSHS Property Listing	Form and Instruction	Modified	Available
Form BLS OSHS Property BLS OSHS Property Listing	Form and Instruction	Modified	Available
Form BLS OSHS FRW-B AAM BLS OSHS Financial Reconciliation Worksheet - AAMC Programs	Form and Instruction	Modified	Available
Form BLS OSHS FRW-B AAM BLS OSHS Financial Reconciliation Worksheet - AAMC Programs	Form and Instruction	Modified	Available
Form BLS OSHS FRW-A BLS OSHS Financial Reconciliation Worksheet - Base Programs	Form and Instruction	Modified	Available
Form BLS OSHS FRW-A BLS OSHS Financial Reconciliation Worksheet - Base Programs	Form and Instruction	Modified	Available
Form BLS OSHS TCF BLS OSHS Transmittal and Certification Form	Form	Modified	Available
Form BLS OSHS TCF BLS OSHS Transmittal and Certification Form	Form	Modified	Available
Form BLS OSHS BV BLS OSHS Budget Variance Request Form	Form and Instruction	Modified	Available
Form BLS OSHS BV BLS OSHS Budget Variance Request Form	Form and Instruction	Modified	Available
Form BLS OSHS BIF BLS OSHS Budget Information Form	Form	Modified	Available
Form BLS OSHS BIF BLS OSHS Budget Information Form	Form	Modified	Available
Note to Reviewer - OSHS CA FY2027 .docx	Justification for No Material/Nonsubstantive Change	Uploaded 2026-04-16	Available
Note to Reviewer - OSHS CA FY2027 .docx	Justification for No Material/Nonsubstantive Change	Uploaded 2026-04-16	Available
OSHS Cooperative Agreement Supporting Statement.docx	Supporting Statement A	Uploaded 2024-03-01	Repair queued
OSHS Cooperative Agreement Supporting Statement.docx	Supporting Statement A	Uploaded 2024-03-01	Available
31 U.S. Code § 6305 - Using cooperative agreements.pdf	Supplementary Document	Uploaded 2021-04-15	Available
31 U.S. Code § 6305 - Using cooperative agreements.pdf	Supplementary Document	Uploaded 2021-04-15	Available
29 U.S. Code § 669 - Research and related activities.pdf	Supplementary Document	Uploaded 2021-04-15	Available
29 U.S. Code § 669 - Research and related activities.pdf	Supplementary Document	Uploaded 2021-04-15	Available
29 U.S. Code § 2.pdf	Supplementary Document	Uploaded 2021-04-15	Available
29 U.S. Code § 2.pdf	Supplementary Document	Uploaded 2021-04-15	Available
29 U.S. Code § 1.pdf	Supplementary Document	Uploaded 2021-04-15	Available
29 U.S. Code § 1.pdf	Supplementary Document	Uploaded 2021-04-15	Available
FR1 1220-0149 (12-8-2023).pdf	Supplementary Document	Uploaded 2024-03-01	Available
FR1 1220-0149 (12-8-2023).pdf	Supplementary Document	Uploaded 2024-03-01	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
264780	Occupational Safety and Health Statistics Cooperative Agreement Application Package	Form and Instruction	Modified	OSHS FY27 Cooperative Agreement
264780	Occupational Safety and Health Statistics Cooperative Agreement Application Package	Form and Instruction	Modified	OSHS FY27 Cooperative Agreement
264780	Occupational Safety and Health Statistics Cooperative Agreement Application Package	Form	Modified	BLS-OSHS Quarterly Financial Report
264780	Occupational Safety and Health Statistics Cooperative Agreement Application Package	Form	Modified	BLS-OSHS Quarterly Financial Report
264780	Occupational Safety and Health Statistics Cooperative Agreement Application Package	Form and Instruction	Modified	BLS OSHS Property Listing
264780	Occupational Safety and Health Statistics Cooperative Agreement Application Package	Form and Instruction	Modified	BLS OSHS Property Listing
264780	Occupational Safety and Health Statistics Cooperative Agreement Application Package	Form and Instruction	Modified	BLS OSHS Financial Reconciliation Worksheet - AAMC Programs
264780	Occupational Safety and Health Statistics Cooperative Agreement Application Package	Form and Instruction	Modified	BLS OSHS Financial Reconciliation Worksheet - AAMC Programs
264780	Occupational Safety and Health Statistics Cooperative Agreement Application Package	Form and Instruction	Modified	BLS OSHS Financial Reconciliation Worksheet - Base Programs
264780	Occupational Safety and Health Statistics Cooperative Agreement Application Package	Form and Instruction	Modified	BLS OSHS Financial Reconciliation Worksheet - Base Programs
264780	Occupational Safety and Health Statistics Cooperative Agreement Application Package	Form	Modified	BLS OSHS Transmittal and Certification Form
264780	Occupational Safety and Health Statistics Cooperative Agreement Application Package	Form	Modified	BLS OSHS Transmittal and Certification Form
264780	Occupational Safety and Health Statistics Cooperative Agreement Application Package	Form and Instruction	Modified	BLS OSHS Budget Variance Request Form
264780	Occupational Safety and Health Statistics Cooperative Agreement Application Package	Form and Instruction	Modified	BLS OSHS Budget Variance Request Form
264780	Occupational Safety and Health Statistics Cooperative Agreement Application Package	Form	Modified	BLS OSHS Budget Information Form
264780	Occupational Safety and Health Statistics Cooperative Agreement Application Package	Form	Modified	BLS OSHS Budget Information Form

ICR Details

OMB Control No: 1220-0149	ICR Reference No: 202604-1220-002
Status: Active	Previous ICR Reference No: 202504-1220-004
Agency/Subagency: DOL/BLS	Agency Tracking No:
Title: BLS Occupational Safety and Health Statistics Cooperative Agreement Application Package
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 05/18/2026
Retrieve Notice of Action (NOA)	Date Received in OIRA: 04/17/2026
Terms of Clearance: No Terms of Clearance with June 2026 non-sub changes.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	06/30/2027	06/30/2027	06/30/2027
Responses	493	0	493
Time Burden (Hours)	462	0	462
Cost Burden (Dollars)	0	0	0

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Abstract: The BLS signs cooperative agreements with States, and political subdivisions thereof, to assist them in developing and administering programs that deal with occupational safety and health statistics and to arrange through these agreements for research to further the objectives of the Occupational Safety and Health Act.

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Authorizing Statute(s): US Code: 29 USC 1 Name of Law: Design and Duties of the Bureau Generally
   US Code: 29 USC 2 Name of Law: Collection, Collation, and Reports of Labor Statistics
   US Code: 29 USC 669 Name of Law: Occupational Safety and Health Act of 1970
   US Code: 31 USC 6305 Name of Law: Federal Grant and Cooperative Agreement Act of 1977
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	88 FR 85657	12/08/2023
30-day Notice:	Federal Register Citation:	Citation Date:
	89 FR 17880	03/12/2024
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

table that charts list of burden

IC Title	Form No.	Form Name
Occupational Safety and Health Statistics Cooperative Agreement Application Package	BLS OSHS BV, BLS OSHS BIF, BLS OSHS TCF, BLS OSHS FRW-A, BLS OSHS FRW-B AAMC, BLS OSHS Property Listing, OSHS2, FY 2027 CA	BLS OSHS Budget Information Form ,   BLS OSHS Budget Variance Request Form ,   BLS OSHS Transmittal and Certification Form ,   BLS OSHS Financial Reconciliation Worksheet - Base Programs ,   BLS OSHS Financial Reconciliation Worksheet - AAMC Programs ,   BLS OSHS Property Listing ,   BLS-OSHS Quarterly Financial Report ,   OSHS FY27 Cooperative Agreement

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ICR Summary of Burden

table that charts list of burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	493	493	0	0	0	0
Annual Time Burden (Hours)	462	462	0	0	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement:

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Annual Cost to Federal Government: $700,000

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     No

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? No

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 04/17/2026

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