Information Collection

Railroad Trespasser Death Study

IC 26504 under ICR 201201-2130-004 · OMB 2130-0563.

Documents and Forms

Document Name Document Type
Form FRA-F-6180.117 Railroad Trespasser Death Study Form
FRA-F-6180.117 Report of Railroad Trespasser Death FRA F 6180.117 (Rev. 1-5-12).doc safetydata.fra.dot.gov/officeofsafety/publicsite/forms.aspx Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Railroad Trespasser Death Study	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-6180.117	Report of Railroad Trespasser Death	FRA F 6180.117 (Rev. 1-5-12).doc	http://safetydata.fra.dot.gov/officeofsafety/publicsite/forms.aspx	Yes	Yes	Paper Only

Line of Business: Transportation

Subfunction: Ground Transportation

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 100	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	1,375	1,375
Annual IC Time Burden (Hours)	115	115
Annual IC Cost Burden (Dollars)	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.