Get Pod 265-e 2011-2025

The POD 265-E form is essential for reporting accidents in a structured and thorough manner. This guide will provide you with clear, step-by-step instructions on how to complete this form online, ensuring that all necessary details are captured accurately.

Follow the steps to accurately complete the POD 265-E online

1. Press the ‘Get Form’ button to access the POD 265-E form and open it in your preferred online editor.
2. Begin filling in the 'To (COE Office)' and 'From' fields at the top of the form with the relevant office and your name.
3. Enter your contact information in the 'Name of person reporting accident' and 'Phone No.' sections.
4. In the 'Accident Information' section, check all applicable boxes detailing the type of accident, including injury, illness, property damage, or fatality.
5. Complete the 'Contractor/Subcontractor' and 'Contract No.' fields to specify which parties were involved in the incident.
6. Provide a precise account of the location of the accident, including the project name and number in the designated area.
7. Fill in the 'Date of Accident' and 'Time of Accident' fields to document when the incident occurred.
8. Record the 'Name of person involved/injured' including last and first name, the age in 'Age', and occupation in 'Occupation'.
9. Describe the activities leading up to the accident in section six, noting tools, equipment, and actions being undertaken.
10. Detail what happened during the accident in section seven, including how the injury or damage occurred.
11. Specify the type of injury, illness, or property damage in section eight.
12. Indicate if the event is recordable according to OSHA standards, and if so, note that an ENG Form 3394 must be submitted.
13. If medical treatment was required, describe the type in section ten and where it was received in section eleven.
14. Report whether the employee was hospitalized overnight, answering accordingly in section twelve.
15. Inquire if the accident resulted in property damage and estimate this value in the suggested sections.
16. Determine if an accident board of investigation is required and complete the necessary notifications in the following sections.
17. Finally, provide the name and title of the individual who will investigate the accident, as well as your signature and date of reporting.
18. Once all fields are filled, save your changes, then download, print, or share the completed form as needed.

Get started on completing the POD 265-E online for a swift and efficient accident reporting process.