Accident/Incident Reporting and Recordkeeping

OMB: 2130-0500

IC ID: 26389

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2130-0500 can be found here:

Documents and Forms

Document Name Document Type
Form FRA F 6180.39i Accident/Incident Reporting and Recordkeeping Form
FRA F 6180.39i Railroad Accident/Incident Notification and Initial Inve FRA F 6180.39i.pdf safetydata.fra.dot.gov/officeofsafety/Forms/Default.asp Form
FRA F 6180.55 Railroad Injury and Illness Summary FRA F 6180.55 (8-10).pdf safetydata.fra.dot.gov/officeofsafety/publicsite/FormsPub.aspx Form
FRA F 6180.55 Railroad Injury and Illness Summary Changes 6180.55.pdf safetydata.fra.dot.gov/officeofsafety/publicsite/FormsPub.aspx Form
FRA F 6180.55a Railroad Injury and Illness Summary FRA F 6180.55a (8-10).pdf safetydata.fra.dot.gov/officeofsafety/publicsite/FormsPub.aspx Form
FRA F 6180.56 Annual Railroad Report of Employee Hours and Casualties, FRA F 6180.56 (8-10).pdf safetydata.fra.dot.gov/officeofsafety/publicsite/FormsPub.aspx Form
FRA F 6180.54 Rail Equipment Accident/Incident Report FRA F 6180.54 (8-10).pdf safetydata.fra.dot.gov/officeofsafety/publicsite/FormsPub.aspx Form
FRA F 6180.54 Rail Equipment Accident/Incident Report Changes FRA F 6180.54.pdf safetydata.fra.dot.gov/officeofsafety/publicsite/FormsPub.aspx Form
FRA F 6180.57 Highway-Rail Grade Crossing Accident/Incident Report FRA F 6180.57 (8-10).pdf safetydata.fra.dot.gov/officeofsafety/publicsite/FormsPub.aspx Form
FRA F 6180.78 Notice to Railroad Employee Involved in Rail Equipment A FRA F 6180.78 (8-10).pdf safetydata.fra.dot.gov/officeofsafety/publicsite/FormsPub.aspx Form
FRA F 6180.81 Employee Human Factor Attachment FRA F 6180.81 (8-10).pdf safetydata.fra.dot.gov/officeofsafety/publicsite/FormsPub.aspx Form
FRA F 6180.98 Initial Rail Equipment Accident/Incident Record fra f 6180.97 (8-10).pdf safetydata.fra.dot.gov/officeofsafety/publicsite/FormsPub.aspx Form
FRA F 6180.98 Railroad Employee Injury and/or Illness Record FRA F 6180.98 (8-10).pdf safetydata.fra.dot.gov/officeofsafety/publicsite/FormsPub.aspx Form
FRA F 6180.107 Alternative Record for Illnesses Claimed to Be Work-Rela FRA F 6180.107 (8-10).pdf safetydata.fra.dot.gov/officeofsafety/publicsite/FormsPub.aspx Form
FRA F 6180.150 Highway User Injury Inquiry Form FRA F 6180.150 (8-10).doc safetydata.fra.dot.gov/officeofsafety/publicsite/FormsPub.aspx Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Accident/Incident Reporting and Recordkeeping	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 49 CFR 225

Information Collection Instruments:

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

Federal Enterprise Architecture Business Reference Module

Line of Business: Transportation

Subfunction: Ground Transportation

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 718	Number of Respondents for Small Entity: 665

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 58 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	139,746	61,744	78,002
Annual IC Time Burden (Hours)	59,432	11,911	47,521
Annual IC Cost Burden (Dollars)	216,000	37,714	178,286

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.