SOII Recontact Survey

Survey of Occupational Injuries and Illnesses

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1220-0045 can be found here:

Documents and Forms

Document Name Document Type
Form Attachment A SOII Recontact Survey Form and Instruction
Attachment B - OSHA 300 Form Request Script.docx Instruction
Attachment A Telephone Questionnaire Attachment A - Telephone Questionnaire.docx Form and Instruction

Information Collection (IC) Details

IC Title:	SOII Recontact Survey	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Unchanged

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	Attachment A	Telephone Questionnaire	Attachment A - Telephone Questionnaire.docx		Yes	No	Printable Only
Instruction			Attachment B - OSHA 300 Form Request Script.docx		Yes	No	Printable Only

Line of Business: General Government

Subfunction: Central Records & Statistical Mgt

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 3,613	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Previously Approved
Annual Number of Responses for this IC	3,613	3,613
Annual IC Time Burden (Hours)	1,213	1,213
Annual IC Cost Burden (Dollars)	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.