Information Collection

Occupational Safety and Health Variance Regulation

IC 199154 under ICR 202201-1218-009 · OMB 1218-0265.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1218-0265 can be found here:

2025-01-16 - Extension without change of a currently approved collection

Documents and Forms

Document Name Document Type
oshaform5-30-1a.pdf Instruction
oshaform5-30-1a.pdf Instruction
oshaform5-30-2a.pdf Instruction
oshaform5-30-2a.pdf Instruction
oshaform5-30-3a.pdf Instruction
oshaform5-30-3a.pdf Instruction
oshaform5-30-4a.pdf Instruction
oshaform5-30-4a.pdf Instruction
experimental_variance_app_checklist.pdf www.osha.gov/dts/otpca/variances/experimental_variance_app_checklist.pdf Instruction
experimental_variance_app_checklist.pdf www.osha.gov/dts/otpca/variances/experimental_variance_app_checklist.pdf Instruction
national_defence_variance_app_checklist.pdf www.osha.gov/dts/otpca/variances/national_defence_variance_app_checklist.pdf Instruction
national_defence_variance_app_checklist.pdf www.osha.gov/dts/otpca/variances/national_defence_variance_app_checklist.pdf Instruction
permanent_variance_app_checklist.pdf www.osha.gov/dts/otpca/variances/permanent_variance_app_checklist.pdf Instruction
permanent_variance_app_checklist.pdf www.osha.gov/dts/otpca/variances/permanent_variance_app_checklist.pdf Instruction
temp_variance_app_checklist.pdf www.osha.gov/dts/otpca/variances/temp_variance_app_checklist.pdf Instruction
temp_variance_app_checklist.pdf www.osha.gov/dts/otpca/variances/temp_variance_app_checklist.pdf Instruction
OSHA's Variance Program _ How to Apply for a Variance _ Occupational Safety and Health Administration.html www.osha.gov/dts/otpca/variances/how_to_apply.html Instruction
OSHA's Variance Program _ How to Apply for a Variance _ Occupational Safety and Health Administration.html www.osha.gov/dts/otpca/variances/how_to_apply.html Instruction
OSHA Form 5-30-1 Experimental Variance Application experimental_variance_app_form.pdf www.osha.gov/dts/otpca/variances/experimental_variance_app_form.pdf Form
OSHA Form 5-30-1 Experimental Variance Application experimental_variance_app_form.pdf www.osha.gov/dts/otpca/variances/experimental_variance_app_form.pdf Form
OSHA Form 5-30-4 National Defense Variance Application national_defence_variance_app_form.pdf www.osha.gov/dts/otpca/variances/national_defence_variance_app_form.pdf Form
OSHA Form 5-30-4 National Defense Variance Application national_defence_variance_app_form.pdf www.osha.gov/dts/otpca/variances/national_defence_variance_app_form.pdf Form
OSHA Form 5-30-3 Permanent Variance Application permanent_variance_app_form.pdf www.osha.gov/dts/otpca/variances/permanent_variance_app_form.pdf Form
OSHA Form 5-30-3 Permanent Variance Application permanent_variance_app_form.pdf www.osha.gov/dts/otpca/variances/permanent_variance_app_form.pdf Form
OSHA Form 5-30-2 Temporary Variance Form temp_variance_app_form.pdf www.osha.gov/dts/otpca/variances/temp_variance_app_form.pdf Form
OSHA Form 5-30-2 Temporary Variance Form temp_variance_app_form.pdf www.osha.gov/dts/otpca/variances/temp_variance_app_form.pdf Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Occupational Safety and Health Variance Regulation	Agency IC Tracking Number:	1218-0265(2018)

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 29 CFR Part 1905 (To search for a specific CFR, visit the Code of Federal Regulations.)

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Instruction			oshaform5-30-1a.pdf		Yes	No	Printable Only
Instruction			oshaform5-30-2a.pdf		Yes	No	Printable Only
Instruction			oshaform5-30-3a.pdf		Yes	No	Printable Only
Instruction			oshaform5-30-4a.pdf		Yes	No	Printable Only
Form	OSHA Form 5-30-1	Experimental Variance Application	experimental_variance_app_form.pdf	https://www.osha.gov/dts/otpca/variances/experimental_variance_app_form.pdf	Yes	No	Fillable Printable
Instruction			experimental_variance_app_checklist.pdf	https://www.osha.gov/dts/otpca/variances/experimental_variance_app_checklist.pdf	Yes	No	Printable Only
Form	OSHA Form 5-30-4	National Defense Variance Application	national_defence_variance_app_form.pdf	https://www.osha.gov/dts/otpca/variances/national_defence_variance_app_form.pdf	Yes	No	Fillable Printable
Instruction			national_defence_variance_app_checklist.pdf	https://www.osha.gov/dts/otpca/variances/national_defence_variance_app_checklist.pdf	Yes	No	Printable Only
Form	OSHA Form 5-30-3	Permanent Variance Application	permanent_variance_app_form.pdf	https://www.osha.gov/dts/otpca/variances/permanent_variance_app_form.pdf	Yes	No	Fillable Printable
Instruction			permanent_variance_app_checklist.pdf	https://www.osha.gov/dts/otpca/variances/permanent_variance_app_checklist.pdf	Yes	No	Printable Only
Form	OSHA Form 5-30-2	Temporary Variance Form	temp_variance_app_form.pdf	https://www.osha.gov/dts/otpca/variances/temp_variance_app_form.pdf	Yes	No	Printable Only
Instruction			temp_variance_app_checklist.pdf	https://www.osha.gov/dts/otpca/variances/temp_variance_app_checklist.pdf	Yes	No	Printable Only
Instruction			OSHA's Variance Program _ How to Apply for a Variance _ Occupational Safety and Health Administration.html	https://www.osha.gov/dts/otpca/variances/how_to_apply.html	Yes	No	Printable Only

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: 12	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	48	48
Annual IC Time Burden (Hours)	366	366
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.