Form 300A at a glance
What it is: OSHA's Form 300A is the Summary of Work-Related Injuries and Illnesses of the U.S. Department of Labor Occupational Safety and Health Administration.
Who signs: A company executive must certify that he or she has examined the OSHA 300 Log and that he or she reasonably believes, based on his or her knowledge of the process by which the information was recorded, that the annual summary is correct and complete.[2]
All establishments covered by Part 1904 must complete this Summary page, even if no work-related injuries or illnesses occurred during the year. Remember to review the Log to verify that the entries are complete and accurate before completing this summary.
A filled-in Form 300A example: a bakery completes its annual summary
How to fill out Form 300A, box by box
Establishment information
Under Establishment information, write your establishment name, then the Street, City, State and ZIP.
Industry description and classification
Write the industry description, for example Manufacture of motor truck trailers. Write the Standard Industrial Classification (SIC), if known, OR the North American Industrial Classification (NAICS), if known, for example 336212.
Number of Cases
Under Number of Cases, write the total number of deaths, the total number of cases with days away from work, the total number of cases with job transfer or restriction and the total number of other recordable cases.
Number of Days
Under Number of Days, write the total number of days away from work and the total number of days of job transfer or restriction.
Employment information
Under Employment information, write the annual average number of employees and the total hours worked by all employees last year.
Injury and Illness Types
Under Injury and Illness Types, write the total number of injuries, skin disorders, respiratory conditions, poisonings, hearing loss and all other illnesses.
Sign here
Under Sign here: I certify that I have examined this document and that to the best of my knowledge the entries are true, accurate, and complete.
Write the Company executive, the Title, the Phone and the Date.
More rules for Form 300A
Employees, former employees, and their representatives have the right to review the OSHA Form 300 in its entirety. They also have limited access to the OSHA Form 301 or its equivalent. See 29 CFR Part 1904.35, in OSHA's recordkeeping rule, for further details on the access provisions for these forms.
At the end of each calendar year, you must: 1904.32(a)(1) Review the OSHA 300 Log to verify that the entries are complete and accurate, and correct any deficiencies identified; 1904.32(a)(2) Create an annual summary of injuries and illnesses recorded on the OSHA 300 Log; 1904.32(a)(3) Certify the summary; and 1904.32(a)(4) Post the annual summary.[2]
You must post a copy of the annual summary in each establishment in a conspicuous place or places where notices to employees are customarily posted.[2]
Common questions about Form 300A
What is the purpose of OSHA Form 300A?
OSHA's Form 300A is the Summary of Work-Related Injuries and Illnesses of the U.S. Department of Labor Occupational Safety and Health Administration. Using the Log, count the individual entries you made for each category. Then write the totals, making sure you have added the entries from every page of the Log. If you had no cases, write 0.
Is there a deadline?
Post this Summary page from February 1 to April 30 of the year following the year covered by the form.
Is there a penalty?
Knowingly falsifying this document may result in a fine.
Sources
[1] Form 300A (Rev. 01/2004), Summary of Work-Related Injuries and Illnesses, U.S. Department of Labor Occupational Safety and Health Administration (the Official source link on this page).
[2] osha.gov, signature_rule (osha.gov). Accessed October 20, 2026.