Get Di 134

This guide provides clear and supportive instructions for completing the Di 134 form online. Designed for easy understanding, this resource will help you navigate each section efficiently.

Follow the steps to complete the Di 134 form accurately.

1. Press the ‘Get Form’ button to access the form and open it in your editing platform.
2. Enter the reporting unit and address. This should reflect the specific department or team responsible for the report.
3. Fill in the name of the person involved in the incident, including last name, first name, and middle initial.
4. Input the age of the person involved in the incident.
5. Mark the sex of the person involved by selecting either 'Male' or 'Female.'
6. Provide the complete address of the person involved, including zip code.
7. Include the Social Security number of the individual, ensuring confidentiality.
8. Record the date and time of the incident in the specified format. For year, month, day, hour, and minute, use numeric entries.
9. Describe the activity being conducted at the time of the incident.
10. Complete the lost time data section with relevant dates indicating unable to perform duties and return to work.
11. Indicate the state where the incident occurred.
12. Select the type of accident or incident from the provided options.
13. Specify the result of the accident or incident.
14. Detail the nature of the injury or illness resulting from the incident.
15. Assess the severity of the injury or illness.
16. Identify the part of the body affected by the incident.
17. Complete the source section regarding what was used, done, or contacted, including necessary details.
18. Report any human factors that may have contributed to the incident.
19. Note any physical or environmental factors involved.
20. Indicate whether the report was sent to the OWCP.
21. Provide details about the property involved, including name, model number, size, make, and type.
22. State the ownership of the property and the amount of property damage in dollars.
23. Craft a narrative of the accident or incident, describing who, what, when, where, and how in a clear and thorough manner.
24. Outline the corrective action taken or planned in relation to the incident.
25. Finally, after ensuring all sections are completed accurately, save your changes, and choose to download, print, or share the completed form as necessary.

Complete your Di 134 form online today for accurate record-keeping and reporting.