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Accident/Incident Reporting and Recordkeeping
Accident/Incident Reporting and Recordkeeping
OMB: 2130-0500
IC ID: 26389
OMB.report
DOT/FRA
OMB 2130-0500
ICR 201806-2130-001
IC 26389
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2130-0500 can be found here:
2023-07-24 - Extension without change of a currently approved collection
2021-11-29 - No material or nonsubstantive change to a currently approved collection
Documents and Forms
Document Name
Document Type
Form FRA F 6180.55
Accident/Incident Reporting and Recordkeeping
Form
FRA F 6180.55 Railroad Injury and Illness Summary
FRA F 6180.55.pdf
safetydata.fra.dot.gov/officeofsafety/publicsite/Forms.aspx
Form
FRA F 6180.55a Railroad Injury and Illness Summary (Continuation Sheet)
FRA F 6180.55a.pdf
safetydata.fra.dot.gov/officeofsafety/publicsite/Forms.aspx
Form
FRA F 6180.54 Rail Equipment Accident/Incident Report
FRA F 6180.54.pdf
/safetydata.fra.dot.gov/officeofsafety/publicsite/Forms.aspx
Form
FRA F 6180.56 Annual Railroad Report of Employee Hours and Casualties
FRA F 6180.56.pdf
safetydata.fra.dot.gov/officeofsafety/publicsite/Forms.aspx
Form
FRA F 6180.57 Highway Rail-Grade Crossing Accident/Incident Report
FRA F 6180.57.pdf
safetydata.fra.dot.gov/officeofsafety/publicsite/Forms.aspx
Form
FRA F 6180.78 Notice to Railroad Employee Involved in Rail Equipment A
FRA F 6180.78.pdf
safetydata.fra.dot.gov/officeofsafety/publicsite/Forms.aspx
Form
FRA F 6180.81 Employee Human Factor Attachment
FRA F 6180.81.pdf
safetydata.fra.dot.gov/officeofsafety/publicsite/Forms.aspx
Form
FRA F 6180.97 Initial Rail Equipment Accident/Incident Record
FRA F 6180.97.pdf
safetydata.fra.dot.gov/officeofsafety/publicsite/Forms.aspx
Form
FRA F 6180.98 Railroad Employee Injury and/or Illness Record
FRA F 6180.98.pdf
safetydata.fra.dot.gov/officeofsafety/publicsite/Forms.aspx
Form
FRA F 6180.107 Alternate Record for Illness Claimed to Be Work Related
FRA F 6180.107.pdf
safetydata.fra.dot.gov/officeofsafety/publicsite/Forms.aspx
Form
FRA F 6180.150 Highway User Injury Inquiry Form
FRA F 6180.150.pdf
safetydata.fra.dot.gov/officeofsafety/publicsite/Forms.aspx
Form
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Accident/Incident Reporting and Recordkeeping
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Modified
Obligation to Respond:
Mandatory
CFR Citation:
49 CFR 225
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form
FRA F 6180.55
Railroad Injury and Illness Summary
FRA F 6180.55.pdf
http://safetydata.fra.dot.gov/officeofsafety/publicsite/Forms.aspx
Yes
Yes
Fillable Fileable
Form
FRA F 6180.55a
Railroad Injury and Illness Summary (Continuation Sheet)
FRA F 6180.55a.pdf
http://safetydata.fra.dot.gov/officeofsafety/publicsite/Forms.aspx
Yes
Yes
Fillable Fileable
Form
FRA F 6180.54
Rail Equipment Accident/Incident Report
FRA F 6180.54.pdf
http:///safetydata.fra.dot.gov/officeofsafety/publicsite/Forms.aspx
Yes
Yes
Fillable Fileable
Form
FRA F 6180.56
Annual Railroad Report of Employee Hours and Casualties by State
FRA F 6180.56.pdf
http://safetydata.fra.dot.gov/officeofsafety/publicsite/Forms.aspx
Yes
Yes
Fillable Fileable
Form
FRA F 6180.57
Highway Rail-Grade Crossing Accident/Incident Report
FRA F 6180.57.pdf
http://safetydata.fra.dot.gov/officeofsafety/publicsite/Forms.aspx
Yes
Yes
Fillable Fileable
Form
FRA F 6180.78
Notice to Railroad Employee Involved in Rail Equipment Accident/Incident Attributed to Employee Human Factor
FRA F 6180.78.pdf
http://safetydata.fra.dot.gov/officeofsafety/publicsite/Forms.aspx
Yes
Yes
Fillable Fileable
Form
FRA F 6180.81
Employee Human Factor Attachment
FRA F 6180.81.pdf
http://safetydata.fra.dot.gov/officeofsafety/publicsite/Forms.aspx
Yes
Yes
Fillable Fileable
Form
FRA F 6180.97
Initial Rail Equipment Accident/Incident Record
FRA F 6180.97.pdf
http://safetydata.fra.dot.gov/officeofsafety/publicsite/Forms.aspx
Yes
Yes
Fillable Fileable
Form
FRA F 6180.98
Railroad Employee Injury and/or Illness Record
FRA F 6180.98.pdf
http://safetydata.fra.dot.gov/officeofsafety/publicsite/Forms.aspx
Yes
Yes
Fillable Fileable
Form
FRA F 6180.107
Alternate Record for Illness Claimed to Be Work Related
FRA F 6180.107.pdf
http://safetydata.fra.dot.gov/officeofsafety/publicsite/Forms.aspx
Yes
Yes
Fillable Fileable
Form
FRA F 6180.150
Highway User Injury Inquiry Form
FRA F 6180.150.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:
744
Number of Respondents for Small Entity:
665
Affected Public:
Private Sector
Private Sector:
Businesses or other for-profits
Percentage of Respondents Reporting Electronically:
58 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
16,500
0
0
0
0
16,500
Annual IC Time Burden (Hours)
1,808
0
0
0
0
1,808
Annual IC Cost Burden (Dollars)
0
0
0
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.