If you are a business owner, then you know that filing your taxes can be a daunting task. However, with the help of Form Fra F 6180 55A, it doesn't have to be! This form is specifically designed for businesses and can make filing your taxes much easier. In this blog post, we will discuss what Form Fra F 6180 55A is and how it can help you file your taxes. We will also provide a link to download the form so that you can get started right away! So, if you're ready to learn more about Form Fra F 6180 55A, keep reading!
| Question | Answer |
|---|---|
| Form Name | Form Fra F 6180 55A |
| Form Length | 1 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 15 sec |
| Other names | fra form 6180 55 fillable, fra 6180 55a form fillable, fra 6180 55, fra form 6180 55 address |
DEPARTMENT OF TRANSPORTATION RAILROAD INJURY AND ILLNESS SUMMARY |
|
|
|
|
|
|
SHEET ____ OF ____ |
||||||||||||||||||
FEDERAL RAILROAD ADMINISTRATION (FRA) |
|
|
|
|
|
(Continuation Sheet) |
|
|
|
|
|
|
|
OMB Approval No.: |
|||||||||||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||||||||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
1. Name of Reporting Railroad |
|
|
|
|
|
|
|
|
|
|
|
2. Alphabetic Code |
|
3. Report Month |
|
|
4. Report Year |
||||||||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
5a. |
|
|
5b. |
5c. |
|
5d. |
|
|
|
|
|
|
|
|
|
|
|
5e. |
|
5f. |
|
5g. |
|||
Accident/Injury Number |
Day |
Time |
|
County |
|
|
|
|
|
|
|
|
|
|
|
State |
|
Type |
|
Age |
|||||
|
|
|
|
of Day |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Person/ |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Job Code |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
5h. |
|
5i. |
5j. |
|
5k. |
|
5l. |
|
5m. |
|
|
5n. |
5o. |
|
5p. |
5q. |
|
|
5r. |
||||||
Drug/ |
|
Injury |
Physical |
|
Location |
|
Event |
|
Result |
|
|
Cause |
Number of |
|
Number of |
Exposure to |
Special Case |
||||||||
Alcohol Test |
Illness |
Act |
|
|
|
|
|
|
|
|
|
|
|
Days Away |
|
Days |
Hazmat |
|
|
Codes |
|||||
A |
D |
Code |
|
|
|
|
|
|
|
|
|
|
|
|
From Work |
|
Restricted |
|
|
|
|
|
|||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
5s. Latitude (optional) |
|
|
|
|
|
|
|
|
5t. |
Longitude (optional) |
|
|
|
|
|
|
|
|
|
|
|
||||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
5u. Narrative (Up to 250 Characters) |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
5a. |
|
|
5b. |
5c. |
|
5d. |
|
|
|
|
|
|
|
|
|
|
|
5e. |
|
5f. |
|
5g. |
|||
Accident/Injury Number |
Day |
Time |
|
County |
|
|
|
|
|
|
|
|
|
|
|
State |
|
Type |
|
Age |
|||||
|
|
|
|
of Day |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Person/ |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Job Code |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
5h. |
|
5i. |
5j. |
|
5k. |
|
5l. |
|
5m. |
|
|
5n. |
5o. |
|
5p. |
5q. |
|
|
5r. |
||||||
Drug/ |
|
Injury |
Physical |
|
Location |
|
Event |
|
Result |
|
|
Cause |
Number of |
|
Number of |
Exposure to |
Special Case |
||||||||
Alcohol Test |
Illness |
Act |
|
|
|
|
|
|
|
|
|
|
|
Days Away |
|
Days |
Hazmat |
|
|
Codes |
|||||
A |
D |
Code |
|
|
|
|
|
|
|
|
|
|
|
|
From Work |
|
Restricted |
|
|
|
|
|
|||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
5s. Latitude (optional) |
|
|
|
|
|
|
|
|
5t. |
Longitude (optional) |
|
|
|
|
|
|
|
|
|
|
|
||||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
5u. Narrative (Up to 250 Characters) |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|||
5a. |
|
|
5b. |
5c. |
|
5d. |
|
|
|
|
|
|
|
|
|
|
|
5e. |
|
5f. |
|
5g. |
|||
Accident/Injury Number |
Day |
Time |
|
County |
|
|
|
|
|
|
|
|
|
|
|
State |
|
Type |
|
Age |
|||||
|
|
|
|
of Day |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Person/ |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Job Code |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
5h. |
|
5i. |
5j. |
|
5k. |
|
5l. |
|
5m. |
|
|
5n. |
5o. |
|
5p. |
5q. |
|
|
5r. |
||||||
Drug/ |
|
Injury |
Physical |
|
Location |
|
Event |
|
Result |
|
|
Cause |
Number of |
|
Number of |
Exposure to |
Special Case |
||||||||
Alcohol Test |
Illness |
Act |
|
|
|
|
|
|
|
|
|
|
|
Days Away |
|
Days |
Hazmat |
|
|
Codes |
|||||
A |
D |
Code |
|
|
|
|
|
|
|
|
|
|
|
|
From Work |
|
Restricted |
|
|
|
|
|
|||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
5s. Latitude (optional) |
|
|
|
|
|
|
|
|
5t. |
Longitude (optional) |
|
|
|
|
|
|
|
|
|
|
|
||||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
5u. Narrative (Up to 250 Characters) |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
NOTE: This report is part of the reporting railroad's accident report pursuant to the accident reports statute and, as such shall not " be admitted as evidence or used for any purpose in any suit or action for damages growing out of any matter mentioned in said report . . . ." 49 U.S.C. 20903.
See 49 C.F.R. 225.7 (b).
FORM FRA F 6180.55a (Revised March 2003)