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Causal Analysis and Countermeasures to Reduce Rail-related Suicides
Causal Analysis and Countermeasures to Reduce Rail-related Suicides
OMB: 2130-0572
IC ID: 179636
OMB.report
DOT/FRA
OMB 2130-0572
ICR 201009-2130-002
IC 179636
( )
Documents and Forms
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
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Causal Analysis and Countermeasures to Reduce Rail-related Suicides
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Modified
Obligation to Respond:
Voluntary
CFR Citation:
Information Collection 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
Federal Enterprise Architecture Business Reference Module
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 %
Requested
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
360
0
0
-5,310
0
5,670
Annual IC Time Burden (Hours)
643
0
0
106
0
537
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
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.