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DoL OSHA Form 4-502 free printable template

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U.S. DEPARTMENT OF LABOR OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATIONFORM NO. 450.2 OMB NO. 12180262 Expiration: 12/31/2020OUTREACH TRAINING PROGRAM REPORT GENERAL INDUSTRY Read instructions before
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How to fill out DoL OSHA Form 4-502

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How to fill out DoL OSHA Form 4-50.2

01
Obtain the DoL OSHA Form 4-50.2 from the official OSHA website or your local OSHA office.
02
Fill out the 'Employer Information' section with your company's name, address, and contact information.
03
Provide details about the injured employee, including their name, job title, and department.
04
Describe the incident in the 'Accident Description' section, including what happened, where it occurred, and the time of the accident.
05
Note the specific injuries sustained by the employee.
06
Include details about any medical treatment provided, including the name of the healthcare provider and location of treatment.
07
Sign and date the form as the employer or authorized representative.
08
Submit the completed Form 4-50.2 to OSHA and keep a copy for your records.

Who needs DoL OSHA Form 4-50.2?

01
All employers in industries regulated by OSHA who have experienced a work-related injury or illness involving an employee must complete the DoL OSHA Form 4-50.2.
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DoL OSHA Form 4-50.2 is a form used by the Occupational Safety and Health Administration (OSHA) to record and report workplace injuries and illnesses.
Employers covered by OSHA regulations, who have 10 or more employees, are generally required to file DoL OSHA Form 4-50.2.
To fill out DoL OSHA Form 4-50.2, employers need to provide information on the injured employee, the nature of the injury, incidents leading to it, and other relevant details such as time, date, and location.
The purpose of DoL OSHA Form 4-50.2 is to help employers document workplace injuries and illnesses, which assists in identifying hazards and preventing future incidents.
Information that must be reported on DoL OSHA Form 4-50.2 includes the employee's name, job title, details of the incident, type of injury, days away from work, and any medical treatment received.
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