Form Dot F 1385 – Fill Out and Use This PDF

The DOT F 1385 form is a comprehensive document used by the U.S. Department of Transportation to collect mandatory drug and alcohol testing data from employers. It serves as a vital tool in complying with the regulations set forth for maintaining a safe and drug-free transportation environment. By filling out this form diligently, employers participate in a nationwide effort to ensure the safety of both employees and the general public.

To start the process of fulfilling your compliance obligations, please click the button below to fill out the form.

Get Form Now Download PDF

Form Dot F 1385 PDF Details

The U.S. Department of Transportation (DOT) takes rigorous steps to maintain safety across various transportation sectors, with the DOT F 1385 form playing a crucial role in this mission. This document, known as the Drug and Alcohol Testing MIS Data Collection Form, serves as a comprehensive report that transportation employers must fill out annually. It covers the calendar year and requires detailed information, including the company's name, address, the name of the certifying official, and contact details. Moreover, it mandates employers to identify the specific DOT agency—such as the Federal Motor Carrier Safety Administration (FMCSA), Federal Aviation Administration (FAA), or others—for which they are reporting. The form rigorously segments data collection into categories like the number of safety-sensitive employees, the variety of employee categories, and detailed drug and alcohol testing data, including the types of tests conducted and the test results. This form embodies the federal commitment to reducing incidents stemming from substance abuse within the transportation industry, requiring employers to play an active role in reporting and compliance. Through these efforts, the DOT aims to bolster the safety of both workers and the public by ensuring that transportation operations are conducted by individuals who meet strict drug and alcohol use standards.

Question	Answer
Form Name	Form Dot F 1385
Form Length	3 pages
Fillable?	No
Fillable fields	0
Avg. time to fill out	45 sec
Other names	dot mis data collection form, form mis collection, dot mis report, fmcsa mis

Form Preview Example

U.S. DEPARTMENT OF TRANSPORTATION DRUG AND ALCOHOL TESTING MIS DATA COLLECTION FORM

	Calendar Year Covered by this Report: ________________			OMB No. 2105-0529
I. Employer:				Form DOT F 1385 (Rev. 5/2008)
Company Name:
Doing Business As (DBA) Name (if applicable):
Address:_______________________________________________________________________________				E-mail: _______________________
Name of Certifying Official:			Signature: _________________________________________________
Telephone: (_____)______________________________________		Date Certified: ___________________________________________________

Prepared by (if different): ________________________________________________________ Telephone: (_____)________________________

C/TPA Name and Telephone (if applicable): __________________________________________________ (_____)________________________

Check the DOT agency for which you are reporting MIS data; and complete the information on that same line as appropriate:

___ FMCSA – Motor Carrier: DOT #: ______________________ Owner-operator: (circle one) YES or NO Exempt (Circle One) YES or NO

___ FAA – Aviation: Certificate # (if applicable): _______________________ Plan / Registration # (if applicable):___________________________

___ PHMSA – Pipeline: (Check) Gas Gathering__ Gas Transmission__ Gas Distribution__ Transport Hazardous Liquids__ Transport Carbon Dioxide__

___ FRA – Railroad: Total Number of observed/documented Part 219 “Rule G” Observations for covered employees: __________________________

___ USCG – Maritime: Vessel ID # (USCG- or State-Issued): ______________________________________ (If more than one vessel, list separately.)
___ FTA – Transit
II. Covered Employees: (A) Enter Total Number Safety-Sensitive Employees In All Employee Categories:
(B) Enter Total Number of Employee Categories:


(C)

	Employee Category	Total Number of Employees	If you have multiple employee categories, complete Sections I
	Employee Category	Total Number of Employees
		in this Category	and II (A) & (B). Take that filled-in form and make one copy for
			each employee category and complete Sections II (C), III, and IV

			for each separate employee category.

III. Drug Testing Data:

Type of Test	Total Number Of Test
Pre-Employment
Random
Post-Accident
Reasonable Susp./Cause
Return-to-Duty
Follow-Up
TOTAL

Results [Should equal the sum of Columns 2, 3, 9, 10, 11, and 12]	Verified Negative Results	Verified Positive Results ~ For One Or More Drugs	Positive For Marijuana

Positive For Cocaine

Positive For PCP

Positive For Opiates

Positive For Amphetamines

Refusal Results

Adulterated	Substituted	“Shy Bladder” ~ With No Medical Explanation	Other Refusals To Submit To Testing

Cancelled Results

IV. Alcohol Testing Data:

Type of Test

Pre-Employment

Random

Post-Accident

Reasonable Susp./Cause

Return-to-Duty

Follow-Up

TOTAL

Total Number Of Screening Test Results [Should equal the sum of Columns 2, 3, 7, and 8]

Screening Tests With Results Below 0.02

Greater

Results 0.02 Or

Screening Tests With

Number Of

Confirmation Tests

Results

Through 0.039

With Results 0.02

Confirmation Tests

Tests	0.04 Or
Confirmation	With Results	Greater

Refusal Results

“Shy Lung” ~ With No Medical Explanation	Other Refusals To Submit To Testing

Cancelled Results

PAPERWORK REDUCTION ACT NOTICE (as required by 5 CFR 1320.21)

A federal agency may not conduct or sponsor, and a person is not required to respond to, nor shall a person be subject to a penalty for failure to comply with a collection of information subject to the requirements of the Paperwork Reduction Act unless that collection of information displays a current valid OMB Control Number. The OMB Control Number for this information collection is 2105-0529. Public reporting for this collection of information is estimated to be approximately 90 minutes per response, including the time for reviewing instructions, completing and reviewing the collection of information. All responses to this collection of information are mandatory. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to: Information Collection Clearance Officer, U.S. Department of Transportation, Office of Drug and Alcohol Policy and Compliance, 1200 New Jersey Avenue, SE, Suite W62-300, Washington, D.C. 20590.

Title 18, USC Section 1001, makes it a criminal offense subject to a maximum fine of $10,000, or imprisonment for not more than 5 years, or both, to knowingly and willfully make or cause to be made any false or fraudulent statements of representations in any matter within the jurisdiction of any agency of the United States.

How to Edit Form Dot F 1385 Online for Free

Using PDF files online is always simple with this PDF editor. Anyone can fill out dot mis data collection form here with no trouble. To keep our editor on the forefront of convenience, we work to implement user-oriented capabilities and enhancements regularly. We're routinely thankful for any feedback - play a pivotal part in revolutionizing PDF editing. All it takes is a couple of simple steps:

Step 1: Open the form inside our editor by hitting the "Get Form Button" above on this page.

Step 2: With this advanced PDF file editor, you could do more than simply fill in blanks. Edit away and make your docs appear high-quality with custom textual content added, or optimize the original input to perfection - all comes with an ability to incorporate just about any graphics and sign the PDF off.

In an effort to complete this form, make certain you provide the required information in each field:

1. Whenever filling in the dot mis data collection form, make sure to incorporate all important fields within its relevant form section. This will help facilitate the work, allowing for your details to be handled quickly and accurately.

Step number 1 in submitting form mis data

2. Once your current task is complete, take the next step – fill out all of these fields - Type of Test, PreEmployment, Random, PostAccident, Reasonable SuspCause, ReturntoDuty, FollowUp, TOTAL, l a t o T, l a u q e d l u o h S s t l u s e, f o m u s e h t, e v i t a g e N d e i f i r e V, s t l u s e R, r o F s t l u s e R, and e v i t i s o P d e i f i r e V with their corresponding information. Make sure to double check that everything has been entered correctly before continuing!

How you can fill in form mis data part 2

3. In this step, have a look at PostAccident, Reasonable SuspCause, ReturntoDuty, FollowUp, and TOTAL. Each one of these have to be taken care of with greatest accuracy.

Always be very mindful when completing ReturntoDuty and TOTAL, since this is the section where a lot of people make mistakes.

Step 3: Once you've reread the information you filled in, click "Done" to conclude your form. Right after registering a7-day free trial account at FormsPal, you will be able to download dot mis data collection form or send it via email immediately. The PDF will also be at your disposal via your personal cabinet with your each modification. With FormsPal, you'll be able to complete forms without needing to worry about database breaches or data entries being distributed. Our protected software helps to ensure that your private details are kept safely.

Form Dot F 1385 – Fill Out and Use This PDF

Form Dot F 1385 PDF Details

Form Preview Example

How to Edit Form Dot F 1385 Online for Free

Form Dot F 1385 isn’t the one you’re looking for?

Related Documents