View Information Collection (IC)

View Information Collection (IC)

IC Title:	Notice of Alleged Safety or Health Hazards (OSHA-7 Form)	Agency IC Tracking Number:	1218-0064(2014)

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation: 29 CFR 1903.11

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	OSHA-7	Notice of Alleged Safety or Health Hazards	OSHA-7 (OSHA.gov, paper form) 05142014.pdf		Yes	Yes	Fillable Fileable Signable
Form and Instruction	OSHA-& On-Line	OSHA Online Complaint Form-Notice of Alleged Safety or Health Hazards	OSHA-7 On-line(2014).docx	http://www.osha.gov/pls/osha7/eComplaintForm.html	Yes	Yes	Fillable Fileable

Federal Enterprise Architecture Business Reference Module

Line of Business: Workforce Management

Subfunction: Worker Safety

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 50,641	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 52 %

	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	50,641	0	0	-74	0	50,715
Annual IC Time Burden (Hours)	13,659	0	0	245	0	13,414
Annual IC Cost Burden (Dollars)	13,659	0	0	12,543	0	1,116

Documents for IC

Title	Document	Date Uploaded
How to File a Complaint with OSHA	How to File a Compaint with OSHA Web Page(2014).docx	05/30/2014

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.