View Information Collection (IC)

View Information Collection (IC)

IC Title:	Census of Fatal Occupational Injuries - State, local, and tribal government	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

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 CFOI - 1	Census of Fatal Occupational Injuries Report	CFOI -1.docx		Yes	Yes	Fillable Fileable
Instruction			Attachment 2B - Letter requesting source documents.docx		No		Paper Only
Instruction			Attachment 2C - FAX requesting death certificates.docx		No		Printable Only
Instruction			Attachment 2A - Followback questionnaire Letter.docx		Yes	No	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: 331	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

	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	15,130	0	0	-2,067	0	17,197
Annual IC Time Burden (Hours)	2,540	0	0	-345	0	2,885
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

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.