Information Collection

State Safety Participation Regulations and Remedial Actions

IC 26407 under ICR 201902-2130-004 · 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⚠️ Notice: This information collection may be referencing outdated material.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

Documents and forms in this information collection
Document Name	Document Type
Form FRA F 6180.33 Railroad Safety Inspector’s Report, Violation of Hours of Service Law State Safety Participation Regulations and Remedial Actions	Form
Form FRA F 6180.96 Inspection Report State Safety Participation Regulations and Remedial Actions	Form
Form FRA F 6180.96a Inspection Report (Continuation sheet) State Safety Participation Regulations and Remedial Actions	Form
Form FRA F 6180.109 Motive Power & Equipment Violation Report Form State Safety Participation Regulations and Remedial Actions	Form
Form FRA FA 6180.110 Hazardous Materials Violation Report Form State Safety Participation Regulations and Remedial Actions	Form
Form FRA F 6180.111 Track Violation Report Form State Safety Participation Regulations and Remedial Actions	Form
Form FRA F 6180.112 Signal &Train Control Violation Report Form State Safety Participation Regulations and Remedial Actions	Form
Form FRA F 6180.144 State Rail Safety Accident Investigation Participation Agreement State Safety Participation Regulations and Remedial Actions	Form
Form FRA F 6180.61 Accident /Incident Reporting Rules Violation Report Form State Safety Participation Regulations and Remedial Actions	Form
Form FRA F 6180.67 Operating Practices Violation Report Form 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	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:

table that charts list of instruments
Document Type	Form No.	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	FRA F 6180.33	http://safetydata.fra.dot.gov/OfficeofSafety/publicsite/Forms.aspx	Yes	Yes	Fillable Fileable
Form	FRA F 6180.96	http://safetydata.fra.dot.gov/OfficeofSafety/publicsite/Forms.aspx	Yes	Yes	Paper Only
Form	FRA F 6180.96a	http://safetydata.fra.dot.gov/OfficeofSafety/publicsite/Forms.aspx	Yes	Yes	Paper Only
Form	FRA F 6180.109	http://safetydata.fra.dot.gov/OfficeofSafety/publicsite/Forms.aspx	Yes	Yes	Paper Only
Form	FRA FA 6180.110	http://safetydata.fra.dot.gov/OfficeofSafety/publicsite/Forms.aspx	Yes	Yes	Paper Only
Form	FRA F 6180.111	http://safetydata.fra.dot.gov/OfficeofSafety/publicsite/Forms.aspx	Yes	Yes	Paper Only
Form	FRA F 6180.112	http://safetydata.fra.dot.gov/OfficeofSafety/publicsite/Forms.aspx	Yes	Yes	Paper Only
Form	FRA F 6180.144	Signal &Train Control Violation Report Form	Yes	Yes	Fillable Fileable
Form	FRA F 6180.61	http://safetydata.fra.dot.gov/OfficeofSafety/publicsite/Forms.aspx	Yes	Yes	Paper Only
Form	FRA F 6180.67	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: 32

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 97 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	23,603	1,251	22,352
Annual IC Time Burden (Hours)	9,346	106	9,240
Annual IC Cost Burden (Dollars)	32,000	1,000	31,000

Documents for IC

table that charts IC Documents
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.

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