Form Dot F 1385 PDF Details

Every year, the IRS releases a new Form Dot F 1385 to help businesses and individuals report their foreign financial assets. The form is used to disclose all of your foreign bank accounts, mutual funds, and other investments. Mishandling this form can lead to serious penalties, so it's important to understand how to correctly complete it. In this blog post, we'll go over the basics of Form Dot F 1385 and show you how to correctly fill it out. Stay tuned for more information on foreign asset reporting later in the year!

QuestionAnswer
Form NameForm Dot F 1385
Form Length3 pages
Fillable?No
Fillable fields0
Avg. time to fill out45 sec
Other namesdot 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

 

 

 

 

 

 

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:

1

2

3

4

5

6

7

8

9

10

11

12

13

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:

1

2

3

4

5

6

7

8

9

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.

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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.

Part # 3 for filling out form mis data

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

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