OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

Evaluating the Effectiveness of Occupational Safety and Health Program Elements in theWholesale Retail Sector

ICR 201206-0920-005 · OMB 0920-0949 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
Non-Respondent Follow-up Interview Form and Instruction New Available
INFORMED CONSENT TO PARTICIPATE IN A LEADING INDICATORS BENCHMARKING RESEARCH PROJECT Form and Instruction New Available
Occupational Safety and Health Program Evaluation Survey Year1 Form and Instruction New Available
Supplemental Document Responses.docx Supplementary Document Uploaded 2012-09-26 Available
BLISS Survey Appearance on Qualtrics.docx Supplementary Document Uploaded 2012-09-26 Available
Section B OSH program 6_11_12.docx Supporting Statement B Uploaded 2012-06-20 Available
Attachment A Authorizing Legislation 5_8_12.docx Supplementary Document Uploaded 2012-06-20 Available
Attachment K OSH Prgm SampleSize Requirements 5_08_12.docx Supplementary Document Uploaded 2012-06-20 Available
Attachment J SurveySampling Strategy 5_08_12.docx Supplementary Document Uploaded 2012-06-20 Available
Attachment F information Security Plan 5_08_12.docx Supplementary Document Uploaded 2012-06-20 Available
Attachment E- US Census Bureau comparison 3 5_08_12.docx Supplementary Document Uploaded 2012-06-20 Available
Attachment E-2 Letter of support 5_08_12.docx Supplementary Document Uploaded 2012-06-20 Available
Attachment E-1 NIOSH ltr of Agreement 5_08_12.docx Supplementary Document Uploaded 2012-06-20 Available
Attachment D-2 Prior OSH Interv Studies 5_08_12.docx Supplementary Document Uploaded 2012-06-20 Available
Attachment D-1CDC'S Broader Research Agenda 5_08_12.docx Supplementary Document Uploaded 2012-06-20 Available
Attachment C - Goals's met by Current Proj 5_ 08_12.docx Supplementary Document Uploaded 2012-06-20 Available
Section A OSH Program 6_11_12.docx Supporting Statement A Uploaded 2012-06-20 Available
IC Document Collections
IC IDCollectionTypeStatusForm
202833 Non-Respondent Follow-up Interview Form and Instruction New
202832 INFORMED CONSENT TO PARTICIPATE IN A LEADING INDICATORS BENCHMARKING RESEARCH PROJECT Form and Instruction New
202831 Occupational Safety and Health Program Evaluation Survey Year1 Form and Instruction New
ICR Details
0920-0949 201206-0920-005
Historical Active
HHS/CDC
Evaluating the Effectiveness of Occupational Safety and Health Program Elements in theWholesale Retail Sector
New collection (Request for a new OMB Control Number)   No
Regular
Approved with change 10/22/2012
Retrieve Notice of Action (NOA) 06/22/2012
Approved consistent with the understanding that the OMB control number along with the standard public burden statement must be displayed on all instruments
  Inventory as of this Action Requested Previously Approved
10/31/2015 36 Months From Approved
9,600 0 0
1,681 0 0
0 0 0
NIOSH proposes to conduct a study to assess the effectiveness of occupational safety and health (OSH) elements (MSDs) among wholesale/ retail trade (WRT) employers The proposed research involves a firm-level survey of a series of organizational metrics considered to be potential predictors of injury and illness WC claim rates and duration in a stratified sample of Ohio Bureau of Workers Compensation (OBWC)-insured WRT firms in Ohio. There are expected to be up to 4,104 participant firms and surveys will be administered twice to the same firms in successive years (e.g. from January- December 2013 and again from January- December 2014). A nested study at 60 firms will ask multiple respondents at each firm to participate.
PL: Pub.L. 91 - 596 20-22 Name of Law: Occupational Safety and Health Act of 1970
  
None
Not associated with rulemaking
  77 FR 9929 02/21/2012
77 FR 37051 06/20/2012
No
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 9,600 0 0 9,600 0 0
Annual Time Burden (Hours) 1,681 0 0 1,681 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
Miscellaneous Actions
No
This is new ICR
$152,454
Yes Part B of Supporting Statement
Yes
No
No
No
Uncollected
Petunia Gissendaner 4046390164
  No
On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
06/22/2012