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                                                                                                                                 OMB No. 1220-0045 
                                                                                                                                  
                                                            U.S. Department of Labor 
     
                                                            Bureau of Labor Statistics 
                                                             
                                  Instructions for Completing the  

            2021 Survey of Occupational Injuries and Illnesses 
                                    
    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  send them to the  Bureau of Labor  Statistics, Occupational Safety and Health Statistics (1220-0045), 2 Massachusetts  Avenue, N.E., 
   Washington, DC 20212. 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 ADDRESS. 
   The Bureau of Labor Statistics, its employees, agents, and partner statistical agencies, will use the information you provide BLS-9300-IDCF 
   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.

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In December 2020, you were notified to participate in the BLS 2021 Survey of Occupational Injuries and Illnesses (SOII) and asked to
maintain records of workplace injuries and illnesses throughout 2021.

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.

BureauU.S. Department of Labor Statisticsof Labor

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

You will need your User ID

User ID: and temporary password if
302203479880
you report using the
Temporary AnsU5155Password:
Internet.

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 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 https://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
https://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 https://www.bls.gov/iif.

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