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Railroad Trespasser Death Study
Railroad Trespasser Death Study
OMB: 2130-0563
IC ID: 26504
OMB.report
DOT/FRA
OMB 2130-0563
ICR 201201-2130-004
IC 26504
( )
Documents and Forms
Document Name
Document Type
Form FRA-F-6180.117
Railroad Trespasser Death Study
Form
FRA-F-6180.117 Report of Railroad Trespasser Death
FRA F 6180.117 (Rev. 1-5-12).doc
safetydata.fra.dot.gov/officeofsafety/publicsite/forms.aspx
Form
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Railroad Trespasser Death Study
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Modified
Obligation to Respond:
Voluntary
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form
FRA-F-6180.117
Report of Railroad Trespasser Death
FRA F 6180.117 (Rev. 1-5-12).doc
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:
100
Number of Respondents for Small Entity:
0
Affected Public:
State, Local, and Tribal Governments
Percentage of Respondents Reporting Electronically:
0 %
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
1,375
0
1,375
0
0
0
Annual IC Time Burden (Hours)
115
0
115
0
0
0
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.