Accident/Incident Reporting and Recordkeeping

Accident/Incident Reporting and Recordkeeping

OMB: 2130-0500

IC ID: 26389

Documents and Forms
Document Name
Document Type
Form
Form
Form
Form
Form
Form
Form and Instruction
Form and Instruction
Form
Form
Form
Form
Information Collection (IC) Details

View Information Collection (IC)

Accident/Incident Reporting and Recordkeeping
 
No Modified
 
Mandatory
 
49 CFR 225

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form FRA F 6180.56 Annual Report of Employee Hours and Casualties, By State FRA F 6180.56.pdf http://safetydata.fra.dot.gov/officeofsafety/Forms/Default.asp Yes No Paper Only
Form and Instruction FRA F 6180.57 Highway-Rail Grade Crossing Accident/Incident Report FRA F 6180.57.pdf http://safetydata.fra.dot.gov/officeofsafety/Forms/Default.asp Yes No Paper Only
Form and Instruction FRA F 6180.78 Notice to Railroad Employee Involved in Rail Equipment Accident/Incident Attributed to Employee Human Factor (Employee Statement Supplementing Railroad Accident Report) FRA F 6180.78.pdf http://safetydata.fra.dot.gov/officeofsafety/Forms.Default.asp Yes No Paper Only
Form FRA F 6180.97 Employee Human Factor Attachment FRA F 6180.97.pdf http://safetydata.fra.dot.gov/officeofsafety/Forms/Default.asp Yes No Paper Only
Form FRA F 6180.98 Railroad Employee Injury and/or Illness Record FRA F 6180.98.pdf http://safetydata.fra.dot.gov/officeofsafety/Forms/Default.asp Yes No Paper Only
Form F RA F 6180.107 Alternative Record For Illness Claimed To Be Work-Related FRA F 6180.107.pdf http://safetydata.fra.dot.gov/officeofsafety/Forms.Default.asp Yes No Paper Only
Form FRA F 6180.99 FRA Batch Control For Magnetic Media FRA F 6180.99.pdf http://safetydata.fra.dot.gov/officeofsafety/Forms.Default.asp Yes No Paper Only
Form FRA F 6180.39i Railroad Accident/Incident Notification and Initial Investigation Report FRA F 6180.39i.pdf http://safetydata.fra.dot.gov/officeofsafety/Forms/Default.asp Yes Yes Fillable Printable
Form FRA F 6180.54 Rail Equipment Accident/Incident Report FRA F 6180.54.pdf http://safetydata.fra.dot.gov/officeofsafety/Forms/Default.asp Yes No Paper Only
Form FRA F 6180.55 Railroad Injury and Illness Summary FRA F 6180.55.pdf http://safetydata.fra.dot.gov/officeofsafety/Forms/Default.asp Yes No Paper Only
Form FRA F 6180.55a Railroad Injury and Illness Summary (Continuation Sheet) FRA F 6180.55a.pdf http://safetydata.fra.dot.gov/officeofsafety/Forms/Default.asp Yes No Paper Only

Transportation Ground Transportation

 

685 0
   
Private Sector Businesses or other for-profits
 
   40 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 78,002 0 1,000 0 0 77,002
Annual IC Time Burden (Hours) 47,521 0 1,500 0 0 46,021
Annual IC Cost Burden (Dollars) 178,286 0 2,286 0 0 176,000

Title Document Date Uploaded
No associated records found
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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