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Household Survey of Occupational Injuries and Illnesses Pilot Test (HSOII)
No New

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction HSOII Questionnaire HSOII Questionnaire HSOII Questionnaire 02282017.docx Yes Yes Fillable Fileable

General Government Central Records & Statistical Mgt


550 0
Individuals or Households
   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 550 0 550 0 0 0
Annual IC Time Burden (Hours) 1,144 0 1,144 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
HSOII Letter HSOII Letter.docx 01/24/2017
HSOII Screening/Recruitment BLS HSOII Pretest recruitment on Cragslist20170306.docx 03/06/2017
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.