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OSHA Form 300 — Recordable Injury Log

Year-by-year log of recordable workplace injuries and illnesses (OSHA 29 CFR 1904).

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Establishment Information

Cases

Case #Employee NameJob TitleDateWhere OccurredInjury / Body PartClassification (check one)Days AwayDays Restr.Injury Type (check one)
DeathDays away from workJob transfer or restrictionOther recordable caseInjurySkin disorderRespiratoryPoisoningHearing lossAll other illnesses

Annual Summary

Total Cases

3

Deaths

0

Days-Away Cases

0

Restricted Cases

0

Other Recordable

0

Total Days Away

0

Total Days Restricted

0

Cases by Injury Type

Injury0
Skin disorder0
Respiratory0
Poisoning0
Hearing loss0
All other illnesses0

Certification

I certify that I have examined this document and that to the best of my knowledge the entries are true, accurate, and complete.

warning

Template only. Establishments with 10 or fewer employees, or in low-hazard industries, may be partially exempt from OSHA 300 recordkeeping. Verify your obligations at osha.gov.

About OSHA Form 300

OSHA Form 300 is the official Log of Work-Related Injuries and Illnesses required under 29 CFR Part 1904. Covered employers must record every work-related injury or illness that results in death, days away from work, restricted work or job transfer, medical treatment beyond first aid, loss of consciousness, or diagnosis by a healthcare professional.

Logs must be maintained for five years following the calendar year covered, and the annual summary (Form 300A) must be posted from February 1 through April 30. Construction (NAICS 23) is not on the partial exemption list — most construction employers must record.