Accident/Incident Reporting and Recordkeeping

Forms and Documents

Document	Type	Status	Availability
AccInc 2130-0500R (2).doc	Supporting Statement A	Uploaded 2018-04-11	Available
Feb. 20, 2018, FR Notice (30-Day; Acc-Inc.).pdf	Supplementary Document	Uploaded 2018-04-09	Available
Dec. 11, 2017, FR Notice (60-Day).pdf	Supplementary Document	Uploaded 2018-04-09	Available
FRA Response to OIG Recommendations.doc	Supplementary Document	Uploaded 2017-06-02	Available
49 CFR 225.doc	Supplementary Document	Uploaded 2007-12-18	Available
49CFR1.49.doc	Supplementary Document	Uploaded 2007-12-18	Available
49 U.S.C. 20103.doc	Supplementary Document	Uploaded 2007-12-18	Available
49 U.S.C. 322(a).doc	Supplementary Document	Uploaded 2007-12-18	Available
49 U.S.C. 103 (c).doc	Supplementary Document	Uploaded 2007-12-18	Repair queued
49 USC 21301-21304.doc	Supplementary Document	Uploaded 2007-12-18	Available
49 U.S.C. 20901-20903.doc	Supplementary Document	Uploaded 2007-12-18	Repair queued

IC Document Collections

IC ID	Collection	Type	Status	Form
26389	Accident/Incident Reporting and Recordkeeping		Modified
231041	Highway User Statement		New
231040	Alternative Record for Illness Claimed to Be Work Related		New
231039	Railroad Employee Injury and/or Illness Record		New
231038	Initial Rail Equipment Accident/Incident Record		New
231037	Employee Human Factor Attachment		New
231036	Notice to Railroad Employees Involved in Rail Equipment Accident/Incident Attributed to Human Factor		New
231035	Highway Rail Grade Crossing Accident/Incident Report		New
231034	Annual Railroad Report of Employee Hours and Casualties, by State		New
231032	Railroad Injury and Illness Summary (Continuation Sheet)		New
231031	Railroad Injury and Illness Summary		New
231022	Rail Equipment Accident/Incident Report		New

ICR Details

OMB Control No: 2130-0500	ICR Reference No: 201804-2130-001
Status: Historical Active	Previous ICR Reference No: 201703-2130-003
Agency/Subagency: DOT/FRA	Agency Tracking No:
Title: Accident/Incident Reporting and Recordkeeping
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 06/06/2018
	Date Received in OIRA: 04/17/2018
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	06/30/2021	36 Months From Approved	06/30/2020
Responses	109,440	0	109,440
Time Burden (Hours)	46,577	0	46,577
Cost Burden (Dollars)	0	0	0

---

Abstract: FRA uses the information obtained through its accident/incident regulations to maintain a current and historical databased so that it can monitor the safety and operational practices of the nation's railroads; to identify and promptly ameliorate hazardous conditions associated with rail transportation; and to assure compliance with Federal railroad safety laws.

---

Authorizing Statute(s): US Code: 49 USC 20901 Name of Law: (Formerly Part of Accident Reports Act)
  

Citations for New Statutory Requirements: None

---

Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

---

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	82 FR 58265	12/11/2017
30-day Notice:	Federal Register Citation:	Citation Date:
	83 FR 7292	02/20/2018
Did the Agency receive public comments on this ICR? Yes

---

Number of Information Collection (IC) in this ICR: 12

IC Title	Form No.	Form Name
Accident/Incident Reporting and Recordkeeping	FRA F 6180.98, FRA F 6180.56, FRA F 6180.107, FRA F 6180.55a, FRA F 6180.150, FRA F6180.55, FRA F 6180.54, FRA F 6180.78, FRA F 6180.97, FRA F 6180.57, FRA F 6180.81
Employee Human Factor Attachment
Rail Equipment Accident/Incident Report
Initial Rail Equipment Accident/Incident Record
Railroad Employee Injury and/or Illness Record
Alternative Record for Illness Claimed to Be Work Related
Railroad Injury and Illness Summary
Railroad Injury and Illness Summary (Continuation Sheet)
Annual Railroad Report of Employee Hours and Casualties, by State
Highway Rail Grade Crossing Accident/Incident Report
Notice to Railroad Employees Involved in Rail Equipment Accident/Incident Attributed to Human Factor
Highway User Statement	FRA F 6180.150

---

ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	109,440	109,440	0	-148,188	148,188	0
Annual Time Burden (Hours)	46,577	46,577	0	-47,968	47,968	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: Yes

Burden Reduction Due to: Miscellaneous Actions

Short Statement: The newly revised Code of Federal Regulations (49 CFR 219.201(a)), effective June 12, 2017, requires post-accident toxicological testing of railroad employees when one or more of five specific requirements are met for certain human-factor categories of highway-rail grade crossing accidents and incidents. In this submission, FRA is revising the instructions for Form FRA F 6180.57 to enable FRA to capture information concerning post-accident toxicological testing for certain human factor, highway-rail grade crossing accidents and incidents in the narrative block of this form. This the program change. FRA is not revising the Form 57 itself at this time. Since the average burden time for Form FRA F 6180.57 has extra time built in for the narrative block in order to add all essential information, it remains unchanged at two hours per form. Thus, the previously total burden of 46,577 hours and 109,440 responses remains unchanged. There are no adjustments at this time. ******Although neither the total burden hours nor the total burden responses have changed, FRA has provided a separate IC for each of the 11 forms that are part of the main submission (thus totaling 12 ICs). The Summary of Burden above reflects the calculations for all 12 ICs and shows FRA is requesting no change from the last approved submission.

---

Annual Cost to Federal Government: $1,000

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     No

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

---

Common Form ICR:  No

---

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 04/17/2018

---