ISLB HOS Complaint Form
Standard online complaint form based on the extracted PDF fields. Fill out the original crew, relief crew, and violation details. Use the form to report why the situation is a violation.
Name
*
First Name
Last Name
Original Crew Information
Date
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
On duty date (original crew)
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
On duty time (original crew)
*
On duty location (original crew)
*
Final terminal
*
Train/Job (original crew)
*
Engineer (original crew)
*
First Name
Middle Name
Last Name
Conductor (original crew)
*
First Name
Middle Name
Last Name
Relieved time (time transportation departed to your location – Limbo time)
*
Relieved location (station location, e.g. IY120, mp271, Minidoka)
*
Total time on duty – hours
*
Total time on duty – minutes
*
Relief Crew Information
Van on duty time (relief crew)
Hour Minutes
AM
PM
AM/PM Option
Crew on duty time (relief crew)
Hour Minutes
AM
PM
AM/PM Option
On duty date (relief crew)
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
On duty location (relief crew)
Train/Job (relief crew)
Engineer (relief crew)
First Name
Middle Name
Last Name
Conductor (relief crew)
First Name
Middle Name
Last Name
Terminal departure time (relief crew)
Hour Minutes
AM
PM
AM/PM Option
Departure location (other than on duty location)
Van number or manager giving ride
Violation Details
Was there a work event prior to departure?
*
Yes
No
Work event prior to departure – train symbol worked
Your notes on why it’s a violation
Submit Complaint
Should be Empty: