Employer's Annual Hazardous Occurrence Report (On-board)

From: Employment and Social Development Canada

Alternate formats

Employer's Annual Hazardous Occurrence Report (On-board) – Reporting year

Organization

  • Organization legal name:
  • Organization ID:
  • Organization common name:
  • Business number
  • Main contact:
  • Email:
  • Business telephone:

(Checkbox) Attestation: I hereby certify, on behalf of my organization, that the information contained in this report is, to the best of my knowledge and belief, true and accurate.

How to complete and submit the EAHOR

Important:

You must report for all federally regulated workplaces. Please add any workplaces if they are not listed on this form. Place mouse over cells with a red triangle in the top right for detailed instructions

Employer information

  • Workplace ID:
  • Workplace name:
  • Headquarters (Y/N):
  • Workplace reference number:

Address of workplace

  • Address:
  • City:
  • Province:
  • Country:
  • Postal code:

Injury data

  • Number of disabling injuries:
  • Number of deaths:
  • Number of minor injuries:
  • Number of other hazardous occurrences:

Employment data

  • Total number of employees:
  • Total number of hours worked:
  • In operation Y/N:
  • Date ceased MM-DD-YYYY:

Comments:

 

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