Accident/Incident Reporting and Recordkeeping

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form FRA F 6180.150 Highway User Injury Inquiry Form	Form	Modified	Available
Form FRA F 6180.107 Alternate Record for Illness Claimed to Be Work Related	Form	Modified	Available
Form FRA F 6180.98 Railroad Employee Injury and/or Illness Record	Form	Modified	Available
Form FRA F 6180.97 Initial Rail Equipment Accident/Incident Record	Form	Modified	Available
Form FRA F 6180.81 Employee Human Factor Attachment	Form	Modified	Available
Form FRA F 6180.78 Notice to Railroad Employee Involved in Rail Equipment Accident/Incident Attributed to Employee Human Factor	Form	Modified	Repair queued
Form FRA F 6180.57 Highway Rail-Grade Crossing Accident/Incident Report	Form	Modified	Available
Form FRA F 6180.56 Annual Railroad Report of Employee Hours and Casualties by State	Form	Modified	Available
Form FRA F 6180.54 Rail Equipment Accident/Incident Report	Form	Modified	Available
Form FRA F 6180.55a Railroad Injury and Illness Summary (Continuation Sheet)	Form	Modified	Available
Form FRA F 6180.55 Railroad Injury and Illness Summary	Form	Modified	Available
AccInc 2130-0500R (2).doc	Supporting Statement A	Uploaded 2018-06-11	Available
Acc-Incident 2130-0500NMC.doc	Justification for No Material/Nonsubstantive Change	Uploaded 2018-06-11	Repair queued
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	Available
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	Available

IC Document Collections

Information collection document groups

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

ICR Details

OMB Control No: 2130-0500	ICR Reference No: 201806-2130-001
Status: Historical Active	Previous ICR Reference No: 201804-2130-001
Agency/Subagency: DOT/FRA	Agency Tracking No:
Title: Accident/Incident Reporting and Recordkeeping
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 06/21/2018
Retrieve Notice of Action (NOA)	Date Received in OIRA: 06/11/2018
Terms of Clearance:

table that charts list comparision

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

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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.

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

Citations for New Statutory Requirements: None

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

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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

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

table that charts list of burden

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

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ICR Summary of Burden

table that charts list 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	0	0	0
Annual Time Burden (Hours)	46,577	46,577	0	0	0	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: No

Burden Reduction Due to:

Short Statement:

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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

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Common Form ICR:  No

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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: 06/11/2018

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