Information Collection

Safety Appliance Concern Recommendation Report; Safety Appliance Standards Guidance Checklist Forms

IC 26506 under ICR 201208-2130-005 · OMB 2130-0565.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2130-0565 can be found here:

Documents and Forms

Document Name Document Type
Form FRA F 6180.4b Safety Appliance Concern Recommendation Report; Safety Appliance Standards Guidance Checklist Forms Form
FRA F 6180.4EZi - Headquarters Procedure for Completing F6180 4 EZ.doc safetydata.fra.dot.gov/officeofsafety/publicsite/Forms.aspx Instruction
FRA_F_6180.4EZi_--_Regions[1].doc safetydata.fra.dot.gov/officeofsafety/publicsite/Forms.aspx Instruction
FRA F 6180.4b Sample Car Checklist for Box and Other House Cars Built Form FRA F 6180 4b 231 1 fill.pdf Safetydata.fra.dot.gov/OfficeofSafety/publicsite/Forms.aspx Form
FRA F 6180.4c Sample Car Checklist for Hopper Cars and High-side Gondo Form FRA F 6180 4c 231 2 fill.pdf Safetydata.fra.dot.gov/OfficeofSafety/publicsite/Forms.aspx Form
FRA F 6180.4d Sample Car Checklist for Drop-end High-side Gondola Cars Form FRA F 6180 4d 231 3 fill.pdf Safetydata.fra.dot.gov/OfficeofSafety/publicsite/Forms.aspx Form
FRA F 6180.4e Sample Car Checklist for Fixed-end Low-side Gondola and Form FRA F 6180 4e 231 4 fill.pdf Safetydata.fra.dot.gov/OfficeofSafety/publicsite/Forms.aspx Form
FRA F 6180.4f Sample Car Checklist for Drop-end Low-side Gondola Cars Form FRA F 6180 4f 231 5 fill.pdf Safetydata.fra.dot.gov/OfficeofSafety/publicsite/Forms.aspx Form
FRA F 6180.4g Sample Car Checklist for Flat Cars Form FRA F 6180 4g 231 6 fill.pdf Safetydata.fra.dot.gov/OfficeofSafety/publicsite/Forms.aspx Form
FRA F 6180.4h Sample Car Checklist for Tank Cars with Side Platforms Form FRA F 6180 4h ( 7) fill.pdf Safetydata.fra.dot.gov/OfficeofSafety/publicsite/Forms.aspx Form
FRA F 6180.4i Sample Car Checklist for Tank Cars with Side Sills and T Form FRA F 6180 4i ( 8) fill.pdf Safetydata.fra.dot.gov/OfficeofSafety/publicsite/Forms.aspx Form
FRA F 6180.4k Sample Car Checklist for Tank Cars without Underframes Form FRA F 6180 4k ( 21) fill.pdf Safetydata.fra.dot.gov/OfficeofSafety/publicsite/Forms.aspx Form
FRA F 6180.4l Sample Car Checklist for Box and Other House Cars withou Form FRA F 6180 4l ( 27) fill.pdf safetydata.fra.dot.gov/OfficeofSafety/publicsite/Forms.aspx Form
FRA F 6180.4m Sample Car Checklist for Box and Other House Cars with R Form FRA F 6180 4m 231 28 fill.pdf safetydata.fra.dot.gov/OfficeofSafety/publicsite/Forms.aspx Form
FRA F 6180.4p Sample Car Checklist for Road Locomotives with Corner St Form FRA F 6180 4p fill.pdf Safetydata.fra.dot.gov/OfficeofSafety/publicsite/Forms.aspx Form
FRA F 6180.4q Sample Car Checklist for Locomotives Used in Switching S Form FRA F 6180 4q fill.pdf Safetydata.fra.dot.gov/OfficeofSafety/publicsite/Forms.aspx Form
FRA F 6180.4EZ Safety Sample Car Inspection Report Form FRA F 6180.4EZ.pdf safetydata.fra.dot.gov/officeofsafety/publicsite/Forms.aspx Form
FRA F 6180.4a MPE Safety Concern Recommendation Report Form FRA F 6180.4a Fillable.pdf safetydata.fra.dot.gov/officeofsafety/publicsite/Forms.aspx Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Safety Appliance Concern Recommendation Report; Safety Appliance Standards Guidance Checklist Forms	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 6180.4b	Sample Car Checklist for Box and Other House Cars Built After October 1, 1966	Form FRA F 6180 4b 231 1 fill.pdf	http://Safetydata.fra.dot.gov/OfficeofSafety/publicsite/Forms.aspx	Yes	Yes	Fillable Fileable
Form	FRA F 6180.4c	Sample Car Checklist for Hopper Cars and High-side Gondolas with Fixed Ends	Form FRA F 6180 4c 231 2 fill.pdf	http://Safetydata.fra.dot.gov/OfficeofSafety/publicsite/Forms.aspx	Yes	Yes	Fillable Fileable
Form	FRA F 6180.4d	Sample Car Checklist for Drop-end High-side Gondola Cars	Form FRA F 6180 4d 231 3 fill.pdf	http://Safetydata.fra.dot.gov/OfficeofSafety/publicsite/Forms.aspx	Yes	Yes	Fillable Fileable
Form	FRA F 6180.4e	Sample Car Checklist for Fixed-end Low-side Gondola and Low-side Hopper Cars	Form FRA F 6180 4e 231 4 fill.pdf	http://Safetydata.fra.dot.gov/OfficeofSafety/publicsite/Forms.aspx	Yes	Yes	Fillable Fileable
Form	FRA F 6180.4f	Sample Car Checklist for Drop-end Low-side Gondola Cars	Form FRA F 6180 4f 231 5 fill.pdf	http://Safetydata.fra.dot.gov/OfficeofSafety/publicsite/Forms.aspx	Yes	Yes	Fillable Fileable
Form	FRA F 6180.4g	Sample Car Checklist for Flat Cars	Form FRA F 6180 4g 231 6 fill.pdf	http://Safetydata.fra.dot.gov/OfficeofSafety/publicsite/Forms.aspx	Yes	Yes	Fillable Fileable
Form	FRA F 6180.4h	Sample Car Checklist for Tank Cars with Side Platforms	Form FRA F 6180 4h ( 7) fill.pdf	http://Safetydata.fra.dot.gov/OfficeofSafety/publicsite/Forms.aspx	Yes	Yes	Fillable Fileable
Form	FRA F 6180.4i	Sample Car Checklist for Tank Cars with Side Sills and Tank Cars with Short Side Sills and End Platforms	Form FRA F 6180 4i ( 8) fill.pdf	http://Safetydata.fra.dot.gov/OfficeofSafety/publicsite/Forms.aspx	Yes	Yes	Fillable Fileable
Form	FRA F 6180.4k	Sample Car Checklist for Tank Cars without Underframes	Form FRA F 6180 4k ( 21) fill.pdf	http://Safetydata.fra.dot.gov/OfficeofSafety/publicsite/Forms.aspx	Yes	Yes	Fillable Fileable
Form	FRA F 6180.4l	Sample Car Checklist for Box and Other House Cars without Roof Hatches	Form FRA F 6180 4l ( 27) fill.pdf	http://safetydata.fra.dot.gov/OfficeofSafety/publicsite/Forms.aspx	Yes	Yes	Fillable Fileable
Form	FRA F 6180.4m	Sample Car Checklist for Box and Other House Cars with Roof Hatches	Form FRA F 6180 4m 231 28 fill.pdf	http://safetydata.fra.dot.gov/OfficeofSafety/publicsite/Forms.aspx	Yes	Yes	Fillable Fileable
Form	FRA F 6180.4p	Sample Car Checklist for Road Locomotives with Corner Stairways	Form FRA F 6180 4p fill.pdf	http://Safetydata.fra.dot.gov/OfficeofSafety/publicsite/Forms.aspx	Yes	Yes	Fillable Fileable
Form	FRA F 6180.4q	Sample Car Checklist for Locomotives Used in Switching Service	Form FRA F 6180 4q fill.pdf	http://Safetydata.fra.dot.gov/OfficeofSafety/publicsite/Forms.aspx	Yes	Yes	Fillable Fileable
Form	FRA F 6180.4EZ	Safety Sample Car Inspection Report	Form FRA F 6180.4EZ.pdf	http://safetydata.fra.dot.gov/officeofsafety/publicsite/Forms.aspx	Yes	Yes	Fillable Fileable
Instruction			FRA F 6180.4EZi - Headquarters Procedure for Completing F6180 4 EZ.doc	http://safetydata.fra.dot.gov/officeofsafety/publicsite/Forms.aspx	Yes	Yes	Printable Only
Instruction			FRA_F_6180.4EZi_--_Regions[1].doc	http://safetydata.fra.dot.gov/officeofsafety/publicsite/Forms.aspx	Yes	Yes	Printable Only
Form	FRA F 6180.4a	MPE Safety Concern Recommendation Report	Form FRA F 6180.4a Fillable.pdf	http://safetydata.fra.dot.gov/officeofsafety/publicsite/Forms.aspx	Yes	Yes	Fillable Fileable

Federal Enterprise Architecture Business Reference Module

Line of Business: Transportation

Subfunction: Ground Transportation

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 130	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 14 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	232	70	162
Annual IC Time Burden (Hours)	244	82	162
Annual IC Cost Burden (Dollars)	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.