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OMB Control No: 1218-0172	ICR Reference No: 202512-1218-001
Status: Received in OIRA	Previous ICR Reference No: 202503-1218-005
Agency/Subagency: DOL/OSHA	Agency Tracking No: 1218-0172 (2026)
Title: Student Data Form
Type of Information Collection: Revision of a currently approved collection	Common Form ICR: No
Type of Review Request: Regular	Date Submitted to OIRA: 05/07/2026

	Requested	Previously Approved
Expiration Date	36 Months From Approved	08/31/2026
Responses	2,100	2,000
Time Burden (Hours)	175	167
Cost Burden (Dollars)	0	0

ICR Summary of Burden

	Total Request	Previously Approved	Change Due to Adjustment in Estimate
Annual Number of Responses	2,100	2,000	100
Annual Time Burden (Hours)	175	167	8
Annual Cost Burden (Dollars)	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: The agency is requesting an adjustment increase of 8 hours in burden going from 167 hours to 175 hours. The increase is the result of an increase in the number of students enrolling at the OSHA Institute. Also, the agency revised the student data form to include supervisory information.

Annual Cost to Federal Government: $5,575

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination. No

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination. Yes

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? No

Agency Contact: Joel Batchelor 202 693-1873 batchelor.joel.e@dol.gov

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