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Highway-Rail Grade Crossing Accident/Incident Report OMB Approval No. 2130-500 Mobile App

This is the official Highway-Rail Grade Crossing Accident/Incident Report for Federal Railroad Administration and records railroad accident information such as: the Name of Reporting Railroad, U.S. Dot Grade Identification Number, Type of Highway User involved, Estimated Vehicle Speed at Time of Impact, and more. This digital form also qualifies for OMB Approval No. 2130-500.

  • Lendlease
  • The Cooperative
  • PG&E
  • Red Bull
  • Mirvac

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Take a peek inside the Highway-Rail Grade Crossing Accident/Incident Report OMB Approval No. 2130-500 Mobile App

Included Features

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Included Fields

Customize to add, remove, or edit any of the fields below.

  • Ico textbox

    1. Name of Reporting Railroad

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    a.

  • Ico textbox

    b.

  • Ico textbox

    2. Name of Other Railroad Involved in Train Accident/Incident

  • Ico textbox

    a.

  • Ico textbox

    b.

  • Ico textbox

    3. Name of Railroad Responsible for Track Maintenance (single entry)

  • Ico textbox

    a.

  • Ico textbox

    b.

  • Ico textbox

    U.

  • Ico date

    5. Date of Accident/Incident

  • Ico time

    6. Time of Accident/Incident

  • Ico textbox

    7. Nearest Railroad Station

  • Ico textbox

    8. Division

  • Ico textbox

    9. Country

  • Ico textbox

    State Abbr.

  • Ico textbox

    11. City (if in a city)

  • Ico textbox

    12. Highway Name or Number

  • Ico dropdown

    a.

  • Ico statictext

  • Ico statictext

    Highway User Involved

  • Ico dropdown

    13. Type

  • Ico textbox

    a.

  • Ico textbox

    Vehcile Speed (est.

  • Ico dropdown

    15. Direction (geographical)

  • Ico dropdown

    16. Position

  • Ico statictext

    Rail Equipment Involved

  • Ico dropdown

    17. Equipment

  • ...and More!

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