ORS Form 4 PPD-4G 

U.S. Department of Labor

Bureau of Labor Statistics 

Occupational Requirements 

Survey

State and local government

The BLS publishes statistical tabulations from this survey that 

may reveal the information reported by individual State and 

local governments. Upon your request, however, the BLS 

will hold the information provided on this survey form in 

confidence.

This report is authorized by law, 31 United States Code §§ 1535/FAR 

17.5 of the Economy Act. Your voluntary cooperation is needed to 

make the results of this survey comprehensive, accurate and timely.

O.M.B. #1220-0189

Expires 8/31/2021

We estimate that it will take an average of 66 minutes to complete this form, including time for reviewing instructions, searching existing data sources, gathering 

and maintaining the data needed, and completing and reviewing this information. If you have any comments regarding this estimate or any other aspect of this 

survey including suggestions for reducing this burden, please send them to the Bureau of Labor Statistics, Office of Compensation and Working Conditions (1220-

0189), 2 Massachusetts Avenue N.E., Washington, D.C. 20212. You are not required to respond to the collection of information unless it displays a currently valid 

OMB control number.

Schedule number: Start: End:

Total Employment: PSO Employment:

Selected Occupations Occ. Emp. FT/PT SOC

1

2

3

4

5

6

7

8

PRINT ADDITIONAL COPIES OF PAGES 2-4, AS NEEDED.
Schedule/Quote: ___________ Work Schedule: ____________

 Job Title Work Schedule Job Description (Y/N) FT/PT 

Job Observation (circle): Yes - requested Yes - offered No

Critical Job Function:

Task List: Minimum Education

Experience

Credentials

 

On the Job Training

10% Tasks: Driving (yes/no)

Vehicle Type?

Supervisory Data:

Lead/Supervisor/Manager/None 

Work Checked: (more than 1x/day, 1x/day, 

At least 1x/week, less than weekly)

Supervisor Present? Y/N

Work-Related Communication:

Verbal Interactions (every few min, more than 1x/hour, more than 1x/day, once per day or less)

Speaking (duration)

People Skills (basic, more than basic)

General Public? Y/N Crowds? Y/N Telework? Y/N
Job Title Work Schedule

Hearing: 

 In-Person Speech? Y/N Telephone? Y/N Other Remote Speech? Y/N Other Sounds? Y/N

 Noise Intensity Level (quiet, moderate, loud, very loud)

 PPE? Y/N

Cognitive:

Control of Work Load? (machinery/equip/software, numerical perf. target, people, self-paced, other)

Work Pace? (consistent-fast, consistent-slow, varies)

Ability to step away? Y/N

Problem Solving? (more than 1x/day, 1x/day, at least 1x/week, at least 1x/month, less than 1x/month)

Sit/Stand/Walk Duration Other Notes

 Sitting 

 Standing/Walking 

 Sitting/Standing at Will Y/N

Lift/Carry (breaks at 1/10/25/50/75/100 lbs)

Most weight ever

2/3 of the time or more

1/3 up to 2/3 of the time

2% up to 1/3 of the time

Seldom (up to 2%)

Pushing/Pulling

Hands/Arms One/Both

Feet/Legs One/Both

Reaching/Manipulation

Overhead Reaching One/Both

At/Below Shoulder Reaching One/Both

Gross Manipulation One/Both

Fine Manipulation One/Both

Foot/Leg Controls One/Both

Traditional Keyboarding

Postural

Work at or below knee level Y/N/Unk

Stooping Reqd/Choice

/No/Unk

Kneeling Reqd/Choice

/No/Unk

Crouching Reqd/Choice

/No/Unk

Crawling Reqd/Choice

/No/Unk
Job Title Work Schedule

Postural – Climbing Duration Other Notes

Ramps or Stairs, Structural Y/N

Ramps or Stairs, Workrelated

Ladders, Ropes, or Scaffolds

High, Exposed Places Y/N PPE

Vision

Near Visual Acuity Y/N

Far Visual Acuity Y/N

Peripheral Vision Y/N

Environmental Conditions

Outdoors

Extreme Heat

Extreme Cold

Wetness

Humidity

Heavy Vibration

Hazardous Contaminants Y/N PPE

Proximity to Moving 

Mechanical Parts Y/N PPE