Information Collection

State Safety Participation Regulations and Remedial Actions

IC 26407 under ICR 201701-2130-003 · OMB 2130-0509.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2130-0509 can be found here:

Documents and Forms

Document Name Document Type
Form FRA F 6180.33 State Safety Participation Regulations and Remedial Actions Form
FRA F 6180.33 Railroad Safety Inspector’s Report, Violation of Hours o FRA F 6180.33.pdf safetydata.fra.dot.gov/OfficeofSafety/publicsite/Forms.aspx Form
FRA F 6180.96 Inspection Report FRA F 6180.96.pdf safetydata.fra.dot.gov/OfficeofSafety/publicsite/Forms.aspx Form
FRA F 6180.96a Inspection Report (Continuation sheet) FRA F 6180.96a.pdf safetydata.fra.dot.gov/OfficeofSafety/publicsite/Forms.aspx Form
FRA F 6180.109 Motive Power & Equipment Violation Report Form FRA F 6180.109.pdf safetydata.fra.dot.gov/OfficeofSafety/publicsite/Forms.aspx Form
FRA FA 6180.110 Hazardous Materials Violation Report Form FRA F 6180.110.pdf safetydata.fra.dot.gov/OfficeofSafety/publicsite/Forms.aspx Form
FRA F 6180.111 Track Violation Report Form FRA F 6180.111.pdf safetydata.fra.dot.gov/OfficeofSafety/publicsite/Forms.aspx Form
FRA F 6180.112 Signal &Train Control Violation Report Form FRA F 6180.112.pdf safetydata.fra.dot.gov/OfficeofSafety/publicsite/Forms.aspx Form
FRA F 6180.144 State Rail Safety Accident Investigation Participation A FRA F 6180.144.doc Signal &Train Control Violation Report Form Form
FRA F 6180.61 Accident /Incident Reporting Rules Violation Report Form FRA F 6180.61.pdf safetydata.fra.dot.gov/OfficeofSafety/publicsite/Forms.aspx Form
FRA F 6180.67 Operating Practices Violation Report Form FRA F 6180.67.pdf safetydata.fra.dot.gov/OfficeofSafety/publicsite/Forms.aspx Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	State Safety Participation Regulations and Remedial Actions	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 49 CFR 212 49 CFR 209

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	FRA F 6180.33	Railroad Safety Inspectorâs Report, Violation of Hours of Service Law	FRA F 6180.33.pdf	http://safetydata.fra.dot.gov/OfficeofSafety/publicsite/Forms.aspx	Yes	Yes	Fillable Fileable
Form	FRA F 6180.96	Inspection Report	FRA F 6180.96.pdf	http://safetydata.fra.dot.gov/OfficeofSafety/publicsite/Forms.aspx	Yes	Yes	Paper Only
Form	FRA F 6180.96a	Inspection Report (Continuation sheet)	FRA F 6180.96a.pdf	http://safetydata.fra.dot.gov/OfficeofSafety/publicsite/Forms.aspx	Yes	Yes	Paper Only
Form	FRA F 6180.109	Motive Power & Equipment Violation Report Form	FRA F 6180.109.pdf	http://safetydata.fra.dot.gov/OfficeofSafety/publicsite/Forms.aspx	Yes	Yes	Paper Only
Form	FRA FA 6180.110	Hazardous Materials Violation Report Form	FRA F 6180.110.pdf	http://safetydata.fra.dot.gov/OfficeofSafety/publicsite/Forms.aspx	Yes	Yes	Paper Only
Form	FRA F 6180.111	Track Violation Report Form	FRA F 6180.111.pdf	http://safetydata.fra.dot.gov/OfficeofSafety/publicsite/Forms.aspx	Yes	Yes	Paper Only
Form	FRA F 6180.112	Signal &Train Control Violation Report Form	FRA F 6180.112.pdf	http://safetydata.fra.dot.gov/OfficeofSafety/publicsite/Forms.aspx	Yes	Yes	Paper Only
Form	FRA F 6180.144	State Rail Safety Accident Investigation Participation Agreement	FRA F 6180.144.doc	Signal &Train Control Violation Report Form	Yes	Yes	Fillable Fileable
Form	FRA F 6180.61	Accident /Incident Reporting Rules Violation Report Form	FRA F 6180.61.pdf	http://safetydata.fra.dot.gov/OfficeofSafety/publicsite/Forms.aspx	Yes	Yes	Paper Only
Form	FRA F 6180.67	Operating Practices Violation Report Form	FRA F 6180.67.pdf	http://safetydata.fra.dot.gov/OfficeofSafety/publicsite/Forms.aspx	Yes	Yes	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: 31	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 97 %

	Approved	Previously Approved
Annual Number of Responses for this IC	22,352	22,352
Annual IC Time Burden (Hours)	9,240	9,240
Annual IC Cost Burden (Dollars)	31,000	31,000

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.