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Agenda
Reg Review
ICR
View Information Collection (IC)
View Information Collection (IC)
IC Title:
Survey of Occupational Injuries and Illnesses - Private Sector
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
Survey Of Occupational Injuries and Illnesses
SOII_SY2020_Long_Form OMB.docx
Yes
Yes
Fillable Printable
Instruction
9300 IDCF - 2019 .docx
Yes
Yes
Fillable Fileable
Form and Instruction
BLS 9300 FAX
Fax Form 2020 Example
AK_2020.docx
Yes
Yes
Fillable Fileable
Form and Instruction
BLS 9300 N06
SOII Data Collection Booklet - Spanish Version
Item 1 - 2019 SOII Spanish Data Collection Book OMB revision.docx
Yes
Yes
Fillable Printable
Instruction
Item 000 - 2020 SOII instructions sheet - nonDJTRITA.docx
Yes
Yes
Fillable Fileable
Form and Instruction
IDCF
Screenshots
SOII IDCF screenshots 2019 (002).docx
Yes
Yes
Fillable Fileable
Form and Instruction
BLS 9300 FAX
SOII FAX form
Fax_form_English_2020 generic.docx
Yes
Yes
Fillable Fileable
Form and Instruction
BLS 9300 FAX
SOII FAX form
Spanish Fax form.pdf
Yes
Yes
Fillable Fileable
Form and Instruction
IDCF
IDCF UPdates for OSHA ITA
SOII IDCF Screenshots Update.pdf
Yes
Yes
Fillable Fileable
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:
207,696
Number of Respondents for Small Entity:
104,849
Affected Public:
Private Sector
Private Sector:
Businesses or other for-profits, Farms, Not-for-profit institutions
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
207,696
0
-4,104
0
0
211,800
Annual IC Time Burden (Hours)
170,303
0
-2,897
0
0
173,200
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Non-response Letter 1
Item 17 - Non-Response letter 1_2019.docx
08/21/2019
Non-response Letter 2
Item 18 - Non-Response letter 2_2020.docx
08/06/2020
SOII Informed Consent Letter
SOII Informed Consent Letter.pdf
08/21/2019
Mandatory Pre-Note 2020
Item 23 - Mandatory Pre-Notification_2020.docx
08/21/2019
2019 Internet Pamphlet
Item 16 - 2019 Internet pamphlet.docx
08/21/2019
2020 Pre-Note Leaflet
Item 5 - 2020 Prenote Leaflet.docx
08/21/2019
2020 SOII Instruction sheet - mandatory prenote
Item 5 - 2020 SOII instructions sheet - Mand_prenote.docx
08/21/2019
Data collection password email
Data_collection_password_email.docx
08/21/2019
Mandatory Prenote email
Mandatory_Prenote_email_message.docx
08/21/2019
Data Collection email
Data_Collection_email_message.docx
08/21/2019
GA opt out letter
Georgia Sample Reduction Letter 2020.docx
10/28/2020
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.