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OSHA's Form 300A (Rev. 01/2004) Summary of Work-Related Injuries and Illnesses Note: You can type input into this form and save it. Because the forms in this record keeping package are fillableiwritable”
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OSHA's Form 300A Rev is a summary of work-related injuries and illnesses that occurred in a specific year in the workplace. It is required by OSHA (Occupational Safety and Health Administration) to be filled out by certain employers.
Employers with more than 10 employees, as well as those in certain high-risk industries, are required to file OSHA's Form 300A Rev.
To fill out OSHA's Form 300A Rev, employers should review their OSHA 300 Log to ensure accuracy and then transfer the summarized information to the Form 300A. The form must be completed with the establishment's name, address, industry classification, annual average number of employees, and other required information.
The purpose of OSHA's Form 300A Rev is to provide a summary of work-related injuries and illnesses to help employers, employees, and OSHA identify hazards, implement preventative measures, and improve workplace safety.
OSHA's Form 300A Rev requires the reporting of the total number of job-related injuries and illnesses, as well as the number of days employees were away from work, on restricted duty, or transferred to another job due to work-related incidents. It also requires the classification of each case by type of injury or illness.
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