ORS Form 4 PPD-4G Revised April 2016

U.S. Department of Labor

Bureau of Labor Statistics 

Occupational Requirements 

Survey

State and local government

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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

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

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Schedule number: Start: End:

Total Employment: PSO Employment:

Selected Occupations Occ. Emp. FT/PT U/N T/I SOC

1

2

3

4

5

6

7

8

PRINT ADDITIONAL COPIES OF PAGES 2-6, AS NEEDED.
Quote:__________________ Schedule:___________________

2

Quote Details

Job Title: Job Description: (Y/N)

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

Job Tasks/Notes Minimum Education

Minimum formal education required? If no 

minimum, must workers be able to read and write?

Pre-Employment Training

Professional certification, state or industry license, 

other pre-employment training required? Type and 

time to obtain?

Experience

Prior work experience required? How much?

Post-Employment Training

Post-employment training (OJT, mentoring, etc.) 

required? Type and how much?

Driving: □Yes □No 

Vehicle Type (if yes): ___________________

SVP
Quote:__________________ Schedule:___________________

3

Cognitive Elements

Decision-making

What is the highest level of independent judgment a worker is expected to use to perform the tasks of this 

occupation?

 Employee uses independent judgment to select from a limited number of predetermined actions. 

 Employee uses independent judgment to determine the most appropriate course of action in 

situations that do not have set responses.

 Employee uses independent judgment to make decisions by choosing from a large number of 

possibilities in situations where a high degree of uncertainty or complexity may exist.

Work Review

How frequently is work checked in the occupation?

 More than once per day.

 Once per day.

 At least once per week, but less than daily.

 Less than weekly.

Pace

Are there faster and slower periods of work?

 Yes

 No

What is the fastest pace performed?

 Rapid with no periods of waiting.

 Steady with rare periods of waiting.

 Unhurried with much time spent observing or waiting, rushed periods rarely or never occur.
Quote:__________________ Schedule:___________________

4

Control of Work Flow

Can a worker intervene and control the flow of work?

 Yes. The worker can change the priority of work tasks or the amount of time 

allotted to complete them.

 No. The work is primarily driven by business processes, production line speed, or 

customer demands.

Adaptability

Work tasks are the regular duties of an occupation. How often do work tasks change in this occupation?

 At least once per day.

 At least once per week, but less than daily.

 At least once per month, but less than weekly.

 Less than monthly, including never.

Work location is the physical site where work is performed. How often does the work location change in this 

occupation?

 Does not change unless it is permanent.

 Changes up to four times a year.

 Changes more than four times a year.

Work schedule is the work hours and days for the occupation set by the employer. Does the work schedule 

change in this occupation?

 Yes

 No
Quote:__________________ Schedule:___________________

5

Personal Contacts

Regular Contacts: People with whom there is an established working relationship.

Other Contacts: People with whom there is no established working relationship.

Select ONLY one (A, B, C, D) for each contact type:

How often does this occupation require verbal interaction (work related) 

with:

Regular 

Contacts

Other 

Contacts

(A) Constantly, every few minutes.

(B) More than once per hour, but not constantly.

(C) More than once per day, but not more than once per hour.

(D) No more than once per day; includes never.

Select ONLY one (A, B, C, D, E) for each contact type:

What type of work-related interactions does this occupation have with: Regular 

Contacts

Other 

Contacts

(A) Exchanging straightforward, factual information.

(B) Coordinating work with others; solving recurring problems with 

cooperative parties.

(C) Some gentle persuading or soft-selling; discussing.

(D) Influencing; hard-selling; asserting control in situations.

(E) Resolving controversial or long-range issues; defending; 

negotiating.

Notes:
Quote:__________________ Schedule:___________________

6

Exertion

Sit/Stand/Walk

Standing and Walking

Sitting

Sitting vs. Standing at Will

Most weight ever

2/3 of the time or more

1/3 up to 2/3 of the time

2% up to to 1/3 of the time

Seldom (up to 2%)

Pushing/Pulling

Hands/Arms One/Both

Feet/Legs One/Both

Feet Only 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

Keyboarding

Traditional

10-Key

Touch

Other (document)

Postural

Stooping

Kneeling

Crouching

Crawling

Climbing Ramps or Stairs

Structure only (non-work related)

Work-related time

Climbing Ladders, Ropes, or Scaffolds

Auditory/Vision

Communicating Verbally

Hearing Requirements

One-on-one

Group

Telephone

Other Sounds

Passage of a Hearing Test

Near Visual Acuity

Far Visual Acuity

Peripheral Vision

Y/N

Y/N

Y/N

Y/N

Y/N

Y/N

Y/N

Y/N

Y/N

Y/N

Lifting/Carrying (lbs.)
Quote:__________________ Schedule:___________________

7

Environmental Conditions

1 2 3 4 5 6 7 8

Outdoors

Extreme Heat (non-weather related)

Extreme Cold (non-weather related)

Wetness (non-weather related)

Humidity (non-weather related)

Heavy Vibration

Hazardous Contaminants*

 (Toxic, Caustic Chemicals; Fumes; Noxious Odors; Dusts)

PPE PPE PPE PPE PPE PPE PPE PPE

Proximity to Moving Mechanical Parts*

PPE PPE PPE PPE PPE PPE PPE PPE

High, Exposed Places*

PPE PPE PPE PPE PPE PPE PPE PPE

Noise Intensity Level*

 (Quiet, Moderately Loud, Loud, Very Loud)

PPE PPE PPE PPE PPE PPE PPE PPE

*Circle PPE if personal protective equipment is present.

Selected Occupation
8

Notes: