Survey of Occupational Injuries and Illnesses - Private Sector

OMB No. 1220-0045
DISTRICT OF COLUMBIA DEPARTMENT OF LABOR
STATE SECONDARY NAME
STREET ADDRESS
MONTGOMERY, AL 36130-3500

U.S. Department of Labor
Bureau of Labor Statistics
For Help
Call:

2023 Establishment ID: 01-203479880-1
Fax:

Report for:
The Unit Description goes here

334-242-3462 ext. 9999
334-242-3463 ext. 9999
334-242-3462 ext. 9999
334-242-3463 ext. 9999
334-242-3333

Please use login credentials below
(Credentials are reset every year)
User ID: 302203479880
Temporary Password: AnsU5155
NAICS: 512110 - Motion Picture and Video Production
PRIMARY COMPANY NAME
{SECONDARY COMPANY NAME}
ADDRESS LINE 1
ADDRESS LINE 2
CITY, STATE ZIP-PLUS+4

12345

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MANDATORY REPORT – DATED MATERIAL
U.S. GOVERNMENT DOCUMENTS ENCLOSED

Instructions for Completing the
2023 Survey of Occupational Injuries and Illnesses
YOUR RESPONSE IS REQUIRED BY LAW WITHIN 30 DAYS
How to Report Your Data


Report your data to the Bureau of Labor Statistics (BLS) online at: https://idcf.bls.gov



Some establishments must also submit data to the Occupational Safety and Health Administration (OSHA). Submitting
data to OSHA does not fulfill the requirement to complete the BLS Survey of Occupational Injuries and Illnesses



Check the User IDs and Establishment IDs if you receive multiple forms; you may have to report data for more than
one establishment



Report case circumstances and worker characteristics both for cases that resulted in days away from work (with or
without days of job transfer or restriction) AND for cases that resulted in days of job transfer or restriction (without
days away from work)



Contact us using the telephone number(s) listed above for questions about this survey
We estimate it will take you an average of 24 minutes to complete this survey (ranging from 10 minutes to 5 hours per package), including time
for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing this
information. If you have any comments regarding the estimates or any other aspect of this survey, including suggestions for reducing this burden,
please email them to the Bureau of Labor Statistics, Occupational Safety and Health Statistics (1220-0045) at OSHS_Public@bls.gov. Persons are
not required to respond to the collection of information unless it displays a currently valid OMB control number. DO NOT SEND THE
COMPLETED FORM TO THIS EMAIL ADDRESS.
The Bureau of Labor Statistics, its employees, agents, and partner statistical agencies, will use the information you provide
for statistical purposes only and will hold the information in confidence to the full extent permitted by law. In accordance
with the Confidential Information Protection and Statistical Efficiency Act (44 U.S.C. 3572) and other applicable Federal
laws, your responses will not be disclosed in identifiable form without your informed consent. Per the Federal Cybersecurity
Enhancement Act of 2015, Federal information systems are protected from malicious activities through cybersecurity
screening of transmitted data.

BLS-9300-IDCF

Under Public Law 91-596, all establishments that receive this survey must complete and return it within 30 days, even if they had no workrelated injuries and illnesses during 2023.

In December 2022, you were notified to participate in the BLS 2023 Survey of Occupational Injuries and Illnesses (SOII) and asked to
maintain records of workplace injuries and illnesses throughout 2023.

Forms to help you complete the survey




OSHA’s Form 300 - Log of Work-Related Injuries and Illnesses; includes all injuries and illnesses for the year
OSHA’s Form 300A - Summary of Work-Related Injuries and Illnesses; includes average employment and total hours worked
OSHA’s Form 301 - Injury and Illness Incident Report; includes detailed injury and illness data
If the detailed case information requested is not recorded on your OSHA forms, please refer to other sources of information you
may have (including your Workers’ Compensation records). Please note, however, that OSHA’s rules
(www.osha.gov/recordkeeping) concerning which injuries and illnesses to record differ from your state’s Workers’
Compensation reporting.

How to Use the BLS Internet Data Collection Facility
Before reporting your data, you must register online with the BLS even if you have done so in previous years or for other BLS surveys.
Please ensure that the individual registering this account will be the person entering data for the Survey of Occupational
Injuries and Illnesses.
1. Type https://idcf.bls.gov directly into your Internet browser. The “s” in “https” is required.
2. Enter the 12-digit User ID in the field labeled “User ID” and the Temporary Password in the field labeled “Password”. Click I
Accept.
U.S. Department of Labor
Bureau of Labor Statistics

For Help
Call: 555-555-5555
555-555-5555
Fax: 555-555-5555

Example
You will need your User ID
and temporary password if
you report using the
Internet.

User ID:
302203479880
Temporary Password:
AnsU5155

NAICS: 512110 - Motion Picture and Video Production

Your NAICS
3. Complete the “Check Email Address”, “Enter New User Information” and “Create a Permanent Password” pages.
4. Click Continue on the “Confirmation Notice” page.
5. Report your data and click Submit when you are finished. Print a copy of the completed survey for your records.
6. You may log onto the website using your User ID number and permanent password at any time to make corrections to your data.
You can report for additional establishment IDs by logging into the survey again, clicking the Continue button on the “Dear
Employer” page, and then clicking Add Establishment.
For alternate reporting methods, please contact your state office at the telephone number listed under “For Help” on the front page.

Need help?





For step-by-step account creation instructions or website technical help, go to http://www.bls.gov/idcf/instructions.htm.
For questions about this survey, contact us using the telephone number(s) listed on the front of this form.
For information about SOII, including frequently asked questions and to download forms, go to
http://www.bls.gov/respondents/iif/.
For information about OSHA record keeping guidelines, go to https://www.osha.gov/recordkeeping/entryfaq.html.
To see how your data will be used, please visit our website at http://www.bls.gov/iif.