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Divison of Safety and Health Public Employee Safety and Health State Office Campus Building 12 Room 158 Albany NY 12240 STATE OF NEW YORK DEPARTMENT OF LABOR SUMMARY OF WORK-RELATED INJURIES AND ILLNESSES FORM SH-900.

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How to fill out the Sh 900 1 Fillable Form online

The Sh 900 1 Fillable Form is essential for summarizing work-related injuries and illnesses. This guide will provide you with clear steps to efficiently complete the form online, ensuring accuracy and compliance with regulations.

Follow the steps to effectively complete the Sh 900 1 Fillable Form online.

  1. Click ‘Get Form’ button to obtain the form and open it in the editor.
  2. Fill in the establishment information, including the establishment name, street address, city, state, and ZIP code. This is crucial for identifying your workplace.
  3. Provide the average number of employees and the total hours worked by all employees last year. If accurate figures are unavailable, refer to Section 2 calculations for approximations.
  4. Enter the industry description, such as 'village fire department', and the North American Industrial Classification System (NAICS) code.
  5. Input the data from the Log of Occupational Injuries and Illnesses (SH 900). You should enter the column totals for each category. If a category has no cases, enter '0'.
  6. In the injuries and illness types section, complete each relevant column based on recorded cases, ensuring accurate totals are reflected.
  7. In the certification section, provide your signature, title, printed name, and the date to verify the accuracy of the information provided.
  8. Once all fields are completed, save your changes, and you can download, print, or share the form as needed.

Complete your Sh 900 1 Fillable Form online today to ensure compliance and enhance workplace safety.

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