ORS FORM PPD-4G 1 August 2023

U.S. Department of Labor

Bureau of Labor Statistics 

Occupational Requirements 

Survey

Government Industry

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

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:

Selected Occupations Occ. Emp. FT/PT SOC

1

2

3

4

5

6

7

8

PRINT ADDITIONAL COPIES OF PAGES 2-4, AS NEEDED.
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Schedule/Quote: ___________ Work Schedule: ____________ Work Schedule Varies: ☐ Yes ☐ No

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

Job Observation: ☐ Yes ☐ 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: 

• Every few minutes

• At least 1x/hour

• At least 1x/day

• At least once per week

• Less than once per week, including

never

Supervisor Present? Y/N
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Work-Related Communication:

Verbal Interactions-Internal Verbal Interactions-External

• Every few minutes • Every few minutes

• At least 1x/hour • At least 1x/hour

• At least 1x/day • At least 1x/day

• At least once per week • At least once per week

• Less than once per week, including never • Less than once per week, including never

Speaking (duration)

People Skills (basic, more than basic)

Public Work Area? Y/N Crowds? Y/N Telework? Y/N

Hearing: 

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

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
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Reaching/Manipulation

Overhead Reaching One/Both

At/Below Shoulder Reaching One/Both

Gross Manipulation One/Both

Fine Manipulation (FM) One/Both

FM includes keyboarding? Y/N/Unk

Foot/Leg Controls One/Both

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

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 (non-weather)

Extreme Cold (non-weather)

Wetness

Humidity (non-weather)

Heavy Vibration

Hazardous Contaminants Y/N PPE

Proximity to Moving 

Mechanical Parts Y/N PPE