Form 300A from a 300 log: worked example

Six cases on the log, sixteen numbers on the summary. Every total below is counted from the table above it.

The log

Case no. (A)	Job title (C)	Most serious outcome (G to J)	Days away (K)	Days transfer or restriction (L)	Type (M)
1	Welder	(H) Days away from work	12	0	(1) Injury
2	Packer	(I) Job transfer or restriction	0	9	(1) Injury
3	Machine operator	(J) Other recordable case	0	0	(5) Hearing loss
4	Painter	(J) Other recordable case	0	0	(2) Skin disorder
5	Forklift driver	(H) Days away from work	31	14	(1) Injury
6	Assembler	(I) Job transfer or restriction	0	3	(1) Injury

The steps

Count the cases in each outcome column. One mark for each case, in the column of its most serious outcome: G 0, H 2, I 2, J 2.
Add up the days. Column K: 12 + 31 = 43. Column L: 9 + 14 + 3 = 26. Case 5 has both, and still counts once, in H.
Count the cases of each type. M1 4, M2 1, M3 0, M4 0, M5 1, M6 0.
Check the two sums. G to J: 0 + 2 + 2 + 2 = 6. M1 to M6: 4 + 1 + 0 + 0 + 1 + 0 = 6. They must be equal.
Add the establishment figures. Annual average number of employees and total hours worked. The worksheet as a calculator.
Have a company executive certify the summary, then post it. Post it no later than February 1 and keep it in place until April 30.

The result, as Form 300A fields and CSV columns

Form 300A	Counts	Total	ITA CSV column
G	Deaths	0	`total_deaths`
H	Cases with days away from work	2	`total_dafw_cases`
I	Cases with job transfer or restriction	2	`total_djtr_cases`
J	Other recordable cases	2	`total_other_cases`
K	Days away from work	43	`total_dafw_days`
L	Days of job transfer or restriction	26	`total_djtr_days`
M1	Injuries	4	`total_injuries`
M2	Skin disorders	1	`total_skin_disorders`
M3	Respiratory conditions	0	`total_respiratory_conditions`
M4	Poisonings	0	`total_poisonings`
M5	Hearing loss	1	`total_hearing_loss`
M6	All other illnesses	0	`total_other_illnesses`

The checks these totals pass

Check from the data dictionary	Here
The sum of M1 to M6 must equal the sum of G to J.	6 = 6
If there are days-away cases (H), there must be days away (K), and K must be at least H.	H 2, K 43
If there are transfer or restriction cases (I), there must be days (L).	I 2, L 26
Annual average employees should be greater than the total number of cases.	More than 6 employees

With the establishment details added, this is one row of the 28-column file: all 300A CSV columns. To test a finished row, use the 300A CSV checker.

Rather not count by hand? Drop the log in and the converter counts G to M from the cases and writes the 300A CSV row.

Open the converter

Short answers

Does a case with both days away and restricted days count twice on Form 300A?

No. Each case is counted once, under its most serious outcome. Its days still go into both day totals, K and L.

Who signs Form 300A?

A company executive. 29 CFR 1904.32(b)(3) says a company executive must certify that he or she has examined the OSHA 300 Log and reasonably believes the annual summary is correct and complete.

When is Form 300A posted?

No later than February 1 of the year following the year covered by the records, and it stays posted until April 30.

Sources

Read on 2026-11-10. OSHA can change these documents; the link is the authority. Logmend is an independent information tool. It is not affiliated with or endorsed by OSHA or the U.S. Department of Labor, and it is not tax, legal or professional advice.