Estimated Respondent (State Consultation Programs) Hour and Cost Burden for Pilot Study

Pilot Study and Prospective Analysis of the Draft Revised Form 33, Safety and Health Program Assessment Worksheet

Documents and Forms

Document Name Document Type
Form 33 Estimated Respondent (State Consultation Programs) Hour and Cost Burden for Pilot Study Form and Instruction
33 On Site Consultation Progam Safety and Health Assessment Draft Revised Form 33 -OSBA no tracked changes 4-28-22 PRA.docx Form and Instruction
33 On Site Consultation Progam Safety and Health Assessment Draft Revised Form 33 -OSBA no tracked changes 4-28-22 PRA.docx Form and Instruction

Information Collection (IC) Details

IC Title:	Estimated Respondent (State Consultation Programs) Hour and Cost Burden for Pilot Study	Agency IC Tracking Number:	1218-0NEW (2022)

Is this a Common Form? No		IC Status: New

Obligation to Respond: Voluntary

CFR Citation: 29 CFR 1908.6 (e)(3) 29 CFR 1908.6 (e)(8) 29 CFR 1908.6 (g)(l)

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	33	On Site Consultation Progam Safety and Health Assessment Worksheet (OSHA Form 33)	Draft Revised Form 33 -OSBA no tracked changes 4-28-22 PRA.docx		No		Printable Only

Line of Business: Workforce Management

Subfunction: Worker Safety

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 200	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	1,171	1,171
Annual IC Time Burden (Hours)	4,660	4,660
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.