Information Collection

Safety Champions Program Participant

IC 213271 under ICR 202603-1218-001 · OMB 1218-0239.

Documents and Forms

Document Name Document Type
SCP Sign up Safety Champions Program Participant Form
SCP Sign up Safety Champions Sign up Form _03-06-2026.pdf www.osha.gov/safety-champions/registration Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Safety Champions Program Participant	Agency IC Tracking Number:	1218-0239(2024)

Is this a Common Form? No		IC Status: Modified

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	N/A	SCP Sign up	Safety Champions Sign up Form _03-06-2026.pdf	https://www.osha.gov/safety-champions/registration	Yes	Yes	Fillable Fileable

Line of Business: Workforce Management

Subfunction: Worker Safety

Privacy Act System of Records
Title: DOL/OSHA-6	FR Citation: 81 FR 25766

Number of Respondents: 60	Number of Respondents for Small Entity: 0

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

Percentage of Respondents Reporting Electronically: 15 %

	Approved	Previously Approved
Annual Number of Responses for this IC	60	60
Annual IC Time Burden (Hours)	990	990
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.

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