Information Collection

Causal Analysis and Countermeasures to Reduce Rail-related Suicides

IC 179636 under ICR 201009-2130-002 · OMB 2130-0572.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form FRA F 6180.125A Causal Analysis and Countermeasures to Reduce Rail-related Suicides	Form
FRA F 6180.125A Protocol for Railway Personnel Involved in Suicide Incid FRA F 6180.125A.doc safety.data.fra.dot.gov/officeofsafety	Form
FRA F 6180.125B Semi-structured Interview for Psychological Autopsy FRA F 6180.125B.doc safetydata.fra.dot.gov/officeofsafety	Form

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	FRA F 6180.125A	Protocol for Railway Personnel Involved in Suicide Incidents	FRA F 6180.125A.doc	http://safety.data.fra.dot.gov/officeofsafety	Yes	No	Paper Only
Form	FRA F 6180.125B	Semi-structured Interview for Psychological Autopsy	FRA F 6180.125B.doc	http://safetydata.fra.dot.gov/officeofsafety	Yes	No	Paper Only

Line of Business: Transportation

Subfunction: Ground Transportation

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 360

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Requested	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	360	-5,310	5,670
Annual IC Time Burden (Hours)	643	106	537
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
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.