225.21--Alternative record for illnesses claimed to be work related--Form FRA F 6180.107

Accident/Incident Reporting and Recordkeeping

OMB: 2130-0500

IC ID: 231040

Documents and Forms

Document Name Document Type
Form FRA F 6180.107 225.21--Alternative record for illnesses claimed to be work related--Form FRA F 6180.107 Form and Instruction
FRA F 6180.107 Alternate Record for Illness Claimed to Be Work Related FRA F 6180.107.pdf railroads.dot.gov/forms-guides-publications/forms/current-forms Form and Instruction