Information Collection

OSHA's Alliance Program (Private Sector)

IC 234833 under ICR 201902-1218-001 · OMB 1218-0274.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1218-0274 can be found here:

Documents and Forms

Document Name Document Type
Form OSHA 12-10.8 OSHA's Alliance Program (Private Sector) Form
OSHA 12-10.1a National Alliance Agreement Template National Alliance Agreement (2-20-19) cover sheet.doc www.osha.gov/dcsp/alliances/template.html Form
OSHA 12-10.1b National Alliance Renewal Agreement Template National Alliance Renewal Agreement (2-20-19) cover sheet.doc www.osha.gov/dcsp/alliances/template.html Form
OSHA 12-10.2a Regional Area Office Alliance Agreement Template Regional_Area Office Agreement (2-20-19) cover sheet.doc www.osha.gov/dcsp/alliances/template.html Form
OSHA 12-10.2b Regional Area Office Alliance Renewal Agreement Template Regional_Area Office Renewal (2-20-19) cover sheet.doc www.osha.gov/dcsp/alliances/template.html Form
OSHA 12-10.7 Biannual Alliance Data Reporting Form Biannual Alliance Data Reporting Form (2-22-19).docx www.osha.gov/dcsp/alliances/template.html Form
OSHA 12-10.3 National Alliance Annual Report Template NO Alliance Annual Report Template (02-22-19).doc www.osha.gov/dcsp/alliances/template.html Form
OSHA 12-10.4 Regional Alliance Annual Report Template Regional Alliance Annual Report Template (2-22-19.docx www.osha.gov/dcsp/alliances/template.html Form
OSHA 12-10.5 Consulate Alliance Template (Mexico) Consulate Alliance Template - Mexico (2-20-19) cover sheet.docx www.osha.gov/dcsp/alliances/template.html Form
OSHA 12-10.6 Consulate Alliance Template (Other Countries) Consulate Alliance Template - Other Countries (2-20-19) cover sheet.doc www.osha.gov/dcsp/alliances/template.html Form
OSHA 12-10.8 Alliance Feedback Questionnaire Evaluation Form - 2-22-19.docx Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	OSHA's Alliance Program (Private Sector)	Agency IC Tracking Number:	1218-0NEW (2019)

Is this a Common Form? No		IC Status: New

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	OSHA 12-10.8	Alliance Feedback Questionnaire	Evaluation Form - 2-22-19.docx		Yes	Yes	Fillable Fileable
Form	OSHA 12-10.1a	National Alliance Agreement Template	National Alliance Agreement (2-20-19) cover sheet.doc	https://www.osha.gov/dcsp/alliances/template.html	Yes	Yes	Fillable Fileable
Form	OSHA 12-10.1b	National Alliance Renewal Agreement Template	National Alliance Renewal Agreement (2-20-19) cover sheet.doc	https://www.osha.gov/dcsp/alliances/template.html	Yes	Yes	Fillable Fileable
Form	OSHA 12-10.2a	Regional Area Office Alliance Agreement Template	Regional_Area Office Agreement (2-20-19) cover sheet.doc	https://www.osha.gov/dcsp/alliances/template.html	Yes	Yes	Fillable Fileable
Form	OSHA 12-10.2b	Regional Area Office Alliance Renewal Agreement Template	Regional_Area Office Renewal (2-20-19) cover sheet.doc	https://www.osha.gov/dcsp/alliances/template.html	Yes	Yes	Fillable Fileable
Form	OSHA 12-10.7	Biannual Alliance Data Reporting Form	Biannual Alliance Data Reporting Form (2-22-19).docx	https://www.osha.gov/dcsp/alliances/template.html	Yes	Yes	Fillable Fileable
Form	OSHA 12-10.3	National Alliance Annual Report Template	NO Alliance Annual Report Template (02-22-19).doc	https://www.osha.gov/dcsp/alliances/template.html	Yes	Yes	Fillable Fileable
Form	OSHA 12-10.4	Regional Alliance Annual Report Template	Regional Alliance Annual Report Template (2-22-19.docx	https://www.osha.gov/dcsp/alliances/template.html	Yes	Yes	Fillable Fileable
Form	OSHA 12-10.5	Consulate Alliance Template (Mexico)	Consulate Alliance Template - Mexico (2-20-19) cover sheet.docx	https://www.osha.gov/dcsp/alliances/template.html	Yes	Yes	Fillable Fileable
Form	OSHA 12-10.6	Consulate Alliance Template (Other Countries)	Consulate Alliance Template - Other Countries (2-20-19) cover sheet.doc	https://www.osha.gov/dcsp/alliances/template.html	Yes	Yes	Fillable Fileable

Federal Enterprise Architecture Business Reference Module

Line of Business: Workforce Management

Subfunction: Worker Safety

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 230	Number of Respondents for Small Entity: 0

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

Percentage of Respondents Reporting Electronically: 90 %

	Approved	Change Due to Potential Violation of the PRA
Annual Number of Responses for this IC	4,594	4,594
Annual IC Time Burden (Hours)	12,992	12,992
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.