What type of report do you wish to make:

Air Conditioning
Sanitation

Enter the date of the occurrence :

-- mm/dd/yy

Carrier:

Amtrak BN CN-IC KCS NS UP Other

Enter your 'on duty terminal' in the space provided below.

Enter your 'train or job ID' in the space provided below.

This train or job:

Originated at this terminal Was a straight footboard run-through Was a run through, but did work

What was your unit consist, first to last?

Did you request to switch the consist?

Yes No

Who did you ask and what was his/her title?

What was the reason for denial?

Did you consider the reason to be valid ?

Yes No

If not, why not?

Does your carrier have a written policy concerning this problem?

Yes No

If yes, what type of written form is it?

General Order General Notice System Order System Notice Local Order Local Notice Other

Please provide the following contact information, this is not a required field, but may be helpful if further info is needed. Your name will be kept confidential:

First Name
Last Name
***BLE Division required field
Street Address
City
State/Province
Zip/Postal Code
Home Phone
E-mail