Information Collection Request

Accident/Incident Reporting and Recordkeeping

ICR 202111-2130-002 · OMB 2130-0500 · Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form FRA F 6180.150 225.21--Highway User Statement--Form FRA F 6180.150 Form and Instruction Modified Repair queued
Form FRA F 6180.107 225.21--Alternative record for illnesses claimed to be work related--Form FRA F 6180.107 Form and Instruction Modified Available
Form FRA F 6180.98 225.21/25--Railroad employee injury and/or illness record--Form FRA F 6180.98 Form and Instruction Modified Available
Form FRA F 6180.97 225.21--Initial rail equipment accident/incident record--Form FRA F 6180.97 Form and Instruction Modified Available
Form FRA F 6180.81 225.12--Rail equipment accident/incident reports alleging human factor as cause--Form FRA F 6180.81 Form and Instruction Modified Available
Form FRA F 6180.78 225.12(b)--Notice to Railroad Employees Involved in Rail Equipment Accident/Incident Attributed to Human Factor--Form FRA F 6180.78 Form and Instruction Modified Repair queued
Form FRA F 6180.57 225.19(a)--Rail-highway grade crossing accident/incident report--Form FRA F 6180.57 Form and Instruction Modified Available
Form FRA F 6180.56 225.21--Annual railroad report of employee hours and casualties, by state--Form FRA F 6180.56 Form and Instruction Modified Available
Form FRA F 6180.55a 225.19(d)--Death, injury, or occupational illness--Form FRA F 6180.55a) Form and Instruction Modified Available
Form FRA F 6180.55 225.21--Railroad injury and illness summary--Form FRA F 6180.55 Form and Instruction Modified Repair queued
Form FRA F 6180.54 225.11--Reporting of accidents/incidents--Form FRA F 6180.54 Form and Instruction Modified Available
2130-0500 Justification Forms.pdf Justification for No Material/Nonsubstantive Change Uploaded 2021-11-23 Repair queued
49 CFR 1.89 Delegations to Federal Railroad Administrator.pdf Supplementary Document Uploaded 2021-05-18 Available
May 17, 2021, FR Notice (30-Day).pdf Supplementary Document Uploaded 2021-05-18 Available
2130-0005_Accident and Incident_Revised.docx Supporting Statement A Uploaded 2021-07-30 Available
Public Outreach Document for Question 8.pdf Supplementary Document Uploaded 2021-04-30 Available
Feb. 18, 2021, FR Notice (60-Day.pdf Supplementary Document Uploaded 2021-04-30 Available
49 CFR 225.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 Repair queued
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 Repair queued

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
26389 225.6 and 225.9--Consolidated and telephonic reportings Unchanged
247103 225.37--Optical media transfer of reports, updates, and amendments Unchanged
247102 225.35--Access to records and reports Unchanged
247101 225.33--Internal Control Plans--Amendments Unchanged
247100 225.27--Retension of records Unchanged
247099 225.25--Posting of monthly summary Unchanged
247098 225.18--Alcohol or drug involvement Unchanged
247097 225.13--Late Reports Unchanged
231041 225.21--Highway User Statement--Form FRA F 6180.150 Form and Instruction Modified
231040 225.21--Alternative record for illnesses claimed to be work related--Form FRA F 6180.107 Form and Instruction Modified
231039 225.21/25--Railroad employee injury and/or illness record--Form FRA F 6180.98 Form and Instruction Modified
231038 225.21--Initial rail equipment accident/incident record--Form FRA F 6180.97 Form and Instruction Modified
231037 225.12--Rail equipment accident/incident reports alleging human factor as cause--Form FRA F 6180.81 Form and Instruction Modified
231036 225.12(b)--Notice to Railroad Employees Involved in Rail Equipment Accident/Incident Attributed to Human Factor--Form FRA F 6180.78 Form and Instruction Modified
231035 225.19(a)--Rail-highway grade crossing accident/incident report--Form FRA F 6180.57 Form and Instruction Modified
231034 225.21--Annual railroad report of employee hours and casualties, by state--Form FRA F 6180.56 Form and Instruction Modified
231032 225.19(d)--Death, injury, or occupational illness--Form FRA F 6180.55a) Form and Instruction Modified
231031 225.21--Railroad injury and illness summary--Form FRA F 6180.55 Form and Instruction Modified
231022 225.11--Reporting of accidents/incidents--Form FRA F 6180.54 Form and Instruction Modified

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
07/31/2023 07/31/2023 07/31/2023
89,057 0 89,057
35,846 0 35,846
0 0 0





Reginfo record details
19
table that charts list of burden
IC Title Form No. Form Name
225.11--Reporting of accidents/incidents--Form FRA F 6180.54 FRA F 6180.54 Rail Equipment Accident/Incident Report
225.12(b)--Notice to Railroad Employees Involved in Rail Equipment Accident/Incident Attributed to Human Factor--Form FRA F 6180.78 FRA F 6180.78 Notice to Railroad Employee Involved in Rail Equipment Accident/Incident Attributed to Employee Human Factor
225.12--Rail equipment accident/incident reports alleging human factor as cause--Form FRA F 6180.81 FRA F 6180.81 Employee Human Factor Attachment
225.13--Late Reports
225.18--Alcohol or drug involvement
225.19(a)--Rail-highway grade crossing accident/incident report--Form FRA F 6180.57 FRA F 6180.57 Highway Rail-Grade Crossing Accident/Incident Report
225.19(d)--Death, injury, or occupational illness--Form FRA F 6180.55a) FRA F 6180.55a Railroad Injury and Illness Summary
225.21--Alternative record for illnesses claimed to be work related--Form FRA F 6180.107 FRA F 6180.107 Alternate Record for Illness Claimed to Be Work Related
225.21--Annual railroad report of employee hours and casualties, by state--Form FRA F 6180.56 FRA F 6180.56 Annual Railroad Report of Employee Hours and Casualties by State
225.21--Highway User Statement--Form FRA F 6180.150 FRA F 6180.150 Highway User Injury Inquiry Form
225.21--Initial rail equipment accident/incident record--Form FRA F 6180.97 FRA F 6180.97 Initial Rail Equipment Accident/Incident Record
225.21--Railroad injury and illness summary--Form FRA F 6180.55 FRA F 6180.55 Railroad Injury and Illness Summary
225.21/25--Railroad employee injury and/or illness record--Form FRA F 6180.98 FRA F 6180.98 Railroad Employee Injury and/or Illness Record
225.25--Posting of monthly summary
225.27--Retension of records
225.33--Internal Control Plans--Amendments
225.35--Access to records and reports
225.37--Optical media transfer of reports, updates, and amendments
225.6 and 225.9--Consolidated and telephonic reportings

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 89,057 89,057 0 0 0 0
Annual Time Burden (Hours) 35,846 35,846 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No