Regulatory, Compliance & Labor
Farm OSHA 300A Summary Template
An outline for an annual injury and illness summary on a farm, used by owners to total the year of incidents and post the results for workers.
Download free PDF1 page, US Letter, prints clean in black and white
TemplateRegulatory, Compliance & LaborFree PDF
Sections on this template
- Establishment name and address
- Year covered
- Total cases from the log
- Cases with days away
- Cases with job restriction
- Injury and illness types
- Annual hours worked estimate
- Certifying official name
- Signature and posting location
How to use this template
Treat the headings as a starting outline. Add detail under each one, and keep the finished copy with your records.
Where to check the details
This sheet is a general template, so confirm specifics with your own manuals, labels and local rules. For current official guidance, start with OSHA and U.S. Department of Labor.
For more in this area, see the Farm Safety. Between chores, farm.FM has farm humor, including Farm Accidents Aren’t Fun, and agribusiness farm stories.