Excess Hours of Service Violations

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Please use this form to report excess hours of service violations.
Without your help, the carrier will continue to have potential violations.

There have been numerous potential HOS violations in Colorado.

We need your help in gathering data in order to give an accurate report to the Federal Railroad Administration.

Please use this form when being relieved or relieving another crew for HOS and DOL relief and reporting to this organization.

Please fill out as much of this form as possible, and with accurate information.
The form is also available here in .pdf format.
Feel free to print it out and carry a few in your grip so that they are always available.

The information you share will be used between SMART-TD and the FRA

Ask your coworker what their organization is doing!

You are either helping us or hurting us.

Excess Hours of Service Violations Request Form

Email

Worked Position for violation

Is this the train symbol the violation occured on?

If no, what is the train symbol the violation occured on?

On duty location:

On duty date: Time:
Was the train secured before you were dead? Yes No

Did the train require a KEY TRAIN securement job briefing?

Person authorizing excess on duty time?
Relieved location:
Date relieved: Time relieved:

Names of relieving crew:

Relief Crew Symbol:
On duty location:
On duty date: Time:
Type of transport to release location: Van Train
Van/Transport Vehicle Number:
Train engine ID/symbol
On duty time of transport:
Final tie up location:
Tie up date: Tie up Time:
Total time on duty:
Questions / Comments:
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