Accident/Incident Reporting and Recordkeeping

Accident/Incident Reporting and Recordkeeping

OMB: 2130-0500

IC ID: 26389

Documents and Forms
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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 6180.39i 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 6180.55 Railroad Injury and Illness Summary FRA F 6180.55 (8-10).pdf http://safetydata.fra.dot.gov/officeofsafety/publicsite/FormsPub.aspx Yes Yes Fillable Printable
Form FRA F 6180.55 Railroad Injury and Illness Summary Changes 6180.55.pdf http://safetydata.fra.dot.gov/officeofsafety/publicsite/FormsPub.aspx Yes Yes Fillable Printable
Form FRA F 6180.55a Railroad Injury and Illness Summary FRA F 6180.55a (8-10).pdf http://safetydata.fra.dot.gov/officeofsafety/publicsite/FormsPub.aspx Yes Yes Fillable Printable
Form FRA F 6180.56 Annual Railroad Report of Employee Hours and Casualties, By State FRA F 6180.56 (8-10).pdf http://safetydata.fra.dot.gov/officeofsafety/publicsite/FormsPub.aspx Yes Yes Fillable Printable
Form FRA F 6180.54 Rail Equipment Accident/Incident Report FRA F 6180.54 (8-10).pdf http://safetydata.fra.dot.gov/officeofsafety/publicsite/FormsPub.aspx Yes Yes Fillable Printable
Form FRA F 6180.54 Rail Equipment Accident/Incident Report Changes FRA F 6180.54.pdf http://safetydata.fra.dot.gov/officeofsafety/publicsite/FormsPub.aspx Yes Yes Fillable Printable
Form FRA F 6180.57 Highway-Rail Grade Crossing Accident/Incident Report FRA F 6180.57 (8-10).pdf http://safetydata.fra.dot.gov/officeofsafety/publicsite/FormsPub.aspx Yes Yes Fillable Printable
Form FRA F 6180.78 Notice to Railroad Employee Involved in Rail Equipment Accident/Incident Attributed to Employee Human Factor FRA F 6180.78 (8-10).pdf http://safetydata.fra.dot.gov/officeofsafety/publicsite/FormsPub.aspx Yes Yes Fillable Printable
Form FRA F 6180.81 Employee Human Factor Attachment FRA F 6180.81 (8-10).pdf http://safetydata.fra.dot.gov/officeofsafety/publicsite/FormsPub.aspx Yes Yes Fillable Printable
Form FRA F 6180.98 Initial Rail Equipment Accident/Incident Record fra f 6180.97 (8-10).pdf http://safetydata.fra.dot.gov/officeofsafety/publicsite/FormsPub.aspx Yes Yes Fillable Printable
Form FRA F 6180.98 Railroad Employee Injury and/or Illness Record FRA F 6180.98 (8-10).pdf http://safetydata.fra.dot.gov/officeofsafety/publicsite/FormsPub.aspx Yes Yes Fillable Printable
Form FRA F 6180.107 Alternative Record for Illnesses Claimed to Be Work-Related FRA F 6180.107 (8-10).pdf http://safetydata.fra.dot.gov/officeofsafety/publicsite/FormsPub.aspx Yes Yes Fillable Printable
Form FRA F 6180.150 Highway User Injury Inquiry Form FRA F 6180.150 (8-10).doc http://safetydata.fra.dot.gov/officeofsafety/publicsite/FormsPub.aspx Yes Yes Fillable Printable

Transportation Ground Transportation

 

718 665
   
Private Sector Businesses or other for-profits
 
   58 %

  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 139,746 0 61,744 0 0 78,002
Annual IC Time Burden (Hours) 59,432 0 11,911 0 0 47,521
Annual IC Cost Burden (Dollars) 216,000 0 37,714 0 0 178,286

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            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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