View Information Collection (IC)
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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
SOII Form
SOII_SY2016_Long_Form.pdf
Yes
No
Fillable Printable
Instruction
2016 SOII instructions sheet - nonDJTR_revised.pdf
Yes
No
Fillable Printable
Form and Instruction
BLS 9300
Spanish SOII Form
Item 1 - 2016 SOII Spanish Data Collection Book.pdf
Yes
No
Fillable Printable
Instruction
IDCF - 2016_revised.pdf
Yes
No
Fillable Printable
Form and Instruction
9300 FAX
SOII Fax Form
01_Alabama_2016.pdf
Yes
Yes
Fillable Fileable
Form and Instruction
IDCF
SOII IDCF
SOII IDCF ADOBE Screenshots.docx
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:
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)
9,042
0
0
625
0
8,417
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
2017 Prenote - Mand
2017 SOII instructions sheet - Mand_prenote_revised.pdf
09/19/2016
Non-response Letter 1
Non-Response letter 1_2016.pdf
06/30/2016
Nonresponse letter 2
Non-Response letter 2_2016.pdf
06/30/2016
Data collection password email
Data_collection_password_email.docx
06/30/2016
Mandatory pre-note email
Mandatory_Prenote_email_message.docx
06/30/2016
Data Collection email message
Data_Collection_email_message.docx
06/30/2016
Informed Consent Letter
SOII Informed Consent Letter.pdf
06/30/2016
Mandatory prenotification
Mandatory Pre-Notification_2017.pdf
06/30/2016
Internet Pamphlet
2016 Internet pamphlet_revised.pdf
09/19/2016
2018 Prenote leaflet
2018 Prenote Leaflet.docx
09/12/2017
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.