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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_SY2021_Long_Form.docx
Yes
Yes
Fillable Printable
Instruction
Item 000 - 2021 SOII instructions sheet - Mandatory.docx
Yes
Yes
Fillable Fileable
Form and Instruction
BLS 9300 FAX
SOII FAX From
Fax_form_English_2021 generic.docx
Yes
Yes
Fillable Fileable
Form and Instruction
BLS 9300 FAX
SOII Fax Form - Spanish
Fax_form_PR_2021_v2.docx
Yes
Yes
Fillable Fileable
Form and Instruction
BLS 9300 Spanish
SOII Spanish Data Collection Book
Item 1 - 2021 SOII Spanish Data Collection Book OMB revision.docx
Yes
Yes
Fillable Printable
Form and Instruction
BLS 9300FAX
Fax Form 2021 Example
AK_2021.docx
Yes
Yes
Fillable Fileable
Instruction
Item 15 - IDCF - Instructions 2021.docx
Yes
Yes
Fillable Fileable
Form and Instruction
IDCF
SOII IDCF Screenshots
OMB_IDCF_Screenshots_20210726.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:
211,800
Number of Respondents for Small Entity:
104,849
Affected Public:
Private Sector
Private Sector:
Farms, Businesses or other for-profits, Not-for-profit institutions
Percentage of Respondents Reporting Electronically:
90 %
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
211,800
0
4,104
0
0
207,696
Annual IC Time Burden (Hours)
170,033
0
-270
0
0
170,303
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
SOII Informed Consent Letter
SOII Informed Consent Letter.pdf
08/21/2019
Mandatory Prenote email
prenote mandatory 2022.msg
07/28/2021
Data Collection email
collection mandatory 2021.msg
07/28/2021
Item 17 - Non-Response letter 1
Item 17 - Non-Response letter 1_2021.docx
06/28/2021
Item 18 Non Response Letter 2 with fax option
Item 18 - Non-Response letter 2_2021 with fax option.docx
06/28/2021
Item 23 - Mandatory Pre-Notification
Item 23 - Mandatory Pre-Notification_2022.docx
06/28/2021
2021 Internet Pamphlet
Item 16 - 2021 Internet pamphlet.docx
06/28/2021
Item 5 2022 Prenote Leaflet
Item 5 - 2022 Prenote Leaflet.docx
06/28/2021
Data Collection Password email
collection mandatory pass.msg
07/28/2021
Prenote manadatory password email
prenote mandatory pass.msg
07/28/2021
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.