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Agenda
Reg Review
ICR
View Information Collection (IC)
View Information Collection (IC)
IC Title:
Survey of Occupational Injuries and Ilnesses - State and Local - Mandatory
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Modified
Obligation to Respond:
Mandatory
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form and Instruction
BLS 9300 N06
Survey of Occupational Injuries and Illnesses
BLS 9300 N06 - SOII_2013_Long_Form.pdf
Yes
Yes
Fillable Printable
Form and Instruction
BLS 9300 N06
Spanish Survey of Occupational Injuries and Illnesses
BLS 9300 N06 - 2013 SOII Spanish Data Collection Book.pdf
Yes
Yes
Fillable Printable
Form and Instruction
BLS 9300 N06
Spanish Data Collection Non Response 1
BLS 9300 N06 - 2013 SOII Spanish Data Collection Book NR1.pdf
Yes
Yes
Fillable Printable
Form and Instruction
BLS 9300 N06
Spanish Data Collect Book Non Response 2
BLS9300 N06 - 2013 SOII Spanish Data Collection Book NR2.pdf
Yes
Yes
Fillable Printable
Form and Instruction
IDCF
IDCF Screen Shots
IDCF-SOII_ Screen Shots.docx
Yes
Yes
Fillable Fileable
Form and Instruction
BLS 9300 FAX
SOII FAX form
FAX Form - 01_Alabama_2013.pdf
Yes
Yes
Fillable Fileable
Form and Instruction
BLS 9300
Survey of Occupational Injuries and Illnesses
SOII PDF Form 2012.docx
Yes
Yes
Fillable Fileable
Instruction
BLS 9300 IDCF - 2013 SOII instructions sheet - DJTR - Mandatory.pdf
Yes
Yes
Printable Only
Instruction
BLS 9300 IDCF - 2013 SOII instructions sheet - nonDJTR Mandatory.pdf
Yes
Yes
Printable Only
Federal Enterprise Architecture Business Reference Module
Line of Business:
General Government
Subfunction:
Central Records & Statistical Mgt
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
13,000
Number of Respondents for Small Entity:
0
Affected Public:
State, Local, and Tribal Governments
Percentage of Respondents Reporting Electronically:
75 %
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
13,000
0
0
0
0
13,000
Annual IC Time Burden (Hours)
8,417
0
0
0
0
8,417
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
2013 Data Collection letter DJTR
Mandatory DJTR letter data collection.pdf
06/04/2013
DJTR Non Response Letter 1
2013 Non-Response letter 1 DJTR.pdf
06/04/2013
DJTR Non Response letter 2
2013 Non-Response letter 2 DJTR.pdf
06/04/2013
Non Response Letter 1 Non DJTR
Non-Response letter 1 - Mandatory.pdf
06/04/2013
Non Response Letter 2 Non DJTR
Non-Response letter 2 - mandatory.pdf
06/04/2013
2014 Pre-note
2014 Mandatory_prenote.pdf
06/04/2013
2014 Pre Note DJTR
2014 Mandatory Pre-Notification-DJTR.pdf
06/04/2013
2012 DJTR Letter
Mandatory DJTR letter data collection.pdf
06/04/2013
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.