Form FRA F 6180.151 FRA F 6180.151 Federal Railroad Administration Alleged Violation and In

Expires 4/30/2023
OMB Control No. 2130-0590
Public reporting burden for this information collection is estimated to average 7 minutes per response,
including the time for searching existing data sources, gathering and maintaining the data needed, and
completing and reviewing the collection of information. According to the Paperwork Reduction Act of
1995 and its implementing regulations, a respondent is not required to respond to, conduct, or sponsor
a collection of information that does not display a currently valid OMB control number. The valid OMB
control number for this information collection is 2130-0590. All responses to this collection of
information are voluntary. Send comments regarding this burden estimate or any other aspect of this
collection, including suggestions for reducing this burden to: Information Collection Officer, Federal
Railroad Administration, 1200 New Jersey Ave S.E., Washington D.C. 20590.

Federal Railroad Administration Alleged Violation and Inquiry Form
Your submission is voluntary and anonymous unless you choose to provide us with
your contact information. Choosing not to provide your contact information may
affect FRA’s ability to follow up with you on the status of the investigation and may
prevent FRA from adequately investigating the alleged violation, complaint, or inquiry.
If you are not comfortable submitting your report through the internet, we recommend
that you submit your report by mail using the address provided below.
Our privacy policy can be viewed at https://www.transportation.gov/dot-website-privacypolicy. All information submitted through this form, including any identifying
information, will be protected and will only be used to contact you if FRA has any
follow up questions.
FRA Alleged Violation and Inquiry Form
Federal Railroad Administration
Office of Railroad Safety
1200 New Jersey Avenue, S.E.
Washington, D.C. 20590
Webform Field
Notes
AVF Collection Questions
Anonymous submissions are
allowed, but FRA strongly encourages
at least one type of contact information
for follow-up communications.
Type:
Dropdown with
Alleged Violation
Complaint
Inquiry

Title:

Dropdown with

First Name:

Mr.
Ms.
Mrs.
Dr.
Mx.
or Ind.
Text Box

Last Name:

Text Box

Email Address:

Text Box

Telephone Number: (---) --- ----

Text Box

Mailing Address:
Separate text boxes for each element rather
than one large box

Street
City
State
Zip Code
Preferred Method of Contact:

Dropdown with

Your Position:

Phone
Email
Dropdown with

Category of Alleged Violation,
Complaint, or Inquiry:

Public Citizen
Railroad Employee
Other
Dropdown menu the same as current one
(except in alphabetical order and delete the
extra “Other” listing)
Drug and Alcohol

Date of Alleged Violation,
Complaint, or Inquiry:
Time of Alleged Violation,
Complaint, or Inquiry:
Location of Alleged Violation,
Complaint, or Inquiry:
Railroad, Company, or Entity that
Committed the Alleged Violation or
is Involved in the Complaint or
Inquiry:

Please provide a description of the
alleged violation, complaint, or
inquiry. Be as specific and detailed
as possible.

Equipment
General Rules and Regulations
Grade Crossing
Hazardous Materials
Hours of Service
Signal and Train Control
Telephone and Radio Communications
Track and Structures
Train Horn
Workplace Safety
Other
Date option such as _ _/_ _/_ _ or dropdown
Time option dropdown with
1-12 and then A.M. or P.M.
Dropdown with states and then dropdown
with city (or dropdown with state and then
separate text box for hand entering city)
Dropdown with the following:
Amtrak
BNSF Railway (BNSF)
CSX Transportation (CSX)
Canadian National (CN)
Canadian Pacific (CP)
Kansas City Southern (KCS)
Norfolk Southern (NS)
Union Pacific (UP)
Other (This option will allow for respondent
to hand enter an answer)
[larger open text box]

When the form is submitted, users who provide an email address will receive an
automated response from FRA.
FRA F 6180.151 (11-2020)